Gaster
Laprascopy Gasterectomy : 78 age old Patient. The patient with superficial gastric carcinoma of the lesser curvature is placed in a modified lithotomy position. The surgeon is between his legs. Four port sites are used. After the stomach is completely, mobilized, the gastro-esophageal junction is cut. The left lateral trocar incision is enlarged to a mini-laparotomy to extract the specimen. The anvil of the circular stapler is placed into the abdominal cavity, the mini-laparotomy is closed. After reinstitution of the pneumoperitoneum, a purse string suture is created and the anvil is introduced into the esophagus. The reconstruction is created as a direct Roux en Y-esophago-jejunostomy performed by a circular stapler. As our technique shows, the laparoscopic total gastrectomy in suitable cases of gastric cancer can be performed safely and exactly. It respects all the rules of oncologic surgery and is combined with all benefits of the minimal access technique.
