β-Shaped intracorporeal Roux-en-Y reconstruction after totally laparoscopic distal gastrectomy

Abstract

Background: The use of laparoscopic gastrectomy for the treatment of gastric cancer has been increasing. Roux-en-Y (R-Y) reconstruction after laparoscopy-assisted distal gastrectomy is now widely used to decrease leakage and prevent reflux. Owing to the need for a less invasive technique, we have developed a new technique for intracorporeal R-Y reconstruction (β reconstruction) after totally laparoscopic distal gastrectomy (TLDG). Methods: In this report, we describe the β reconstruction technique and short-term outcomes of the initial 105 patients who underwent β reconstruction from December 2008 to March 2012. Results: The operative and β reconstruction times were 330 ± 61.3 and 29 ± 5.6 min (mean ± SD), respectively. Anastomotic leakage after gastrojejunostomy occurred in one patient (0.9 %), requiring reoperation. Four cases (3.8 %) of anastomotic stenosis required endoscopic balloon dilation. However, R-Y stasis was not noted. Conclusions: We have indicated a technical description as well as the usefulness of β-shaped intracorporeal R-Y reconstruction after TLDG. © 2013 The International Gastric Cancer Association and The Japanese Gastric Cancer Association.