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HOME > J Surg Innov Educ > Volume 1(1); 2024 > Article
Dynamic Educational Manuscript
 Laparoscopic Pylorus Preserving Gastrectomy with Intra-Corporeal Gastro-Gastrostomy Guided by Intra-Operative Gastroscopy
Mohd Firdaus Che Ani1,3orcid, Zhuang Chun1,4orcid, Abdullah Almayouf1, Jee-sun Kim1,2orcid, Seong-Ho Kong1,2orcid, Do-Joong Park1,2orcid, Han-Kwang Yang1,2orcid, Hyuk-Joon Lee1,2orcid
Journal of Surgical Innovation and Education 2024;1(1):28-29.
DOI: https://doi.org/10.69474/jsie.2024.00059
Published online: June 25, 2024

1Division of Gastrointestinal Surgery, Department of Surgery, Seoul National University Hospital, Seoul, Republic of Korea

2Department of Surgery, Seoul National University College of Medicine, Seoul, Republic of Korea

3Department of Surgery, Faculty of Medicine, Universiti Teknologi MARA, Selangor, Malaysia

4Department of Gastrointestinal Surgery, Renji Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China

Corresponding author: Hyuk-Joon Lee, MD, PhD Department of Surgery and Cancer Research Institute, Seoul National University College of Medicine; Division of Gastrointestinal Surgery, Seoul National University Hospital; Gastric Cancer Center, Seoul National University Cancer Hospital, 101 Daehak-ro, Jongno-gu, Seoul 03080, Republic of Korea Tel: +82-2-2072-1957, E-mail: 'appe98@snu.ac.kr'
• Received: June 3, 2024   • Revised: June 19, 2024   • Accepted: June 19, 2024

© 2024 Korean Surgical Skill Study Group

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (https://creativecommons.org/licenses/by-nc/4.0) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

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  • Gastric cancer detection is advancing to a point where screening programs can detect gastric cancer at early stages. This allows surgical procedures to be less radical than before. Studies have proven that pylorus preserving gastrectomy is a safe procedure in early T1a and T1b gastric cancers where the tumour location is in the middle third of the stomach. However, due to the small tumour size, determining an appropriate resection margin can be challenging. A few techniques have been developed to overcome this difficulty, and at our centre, we perform intra-operative gastroscopy to synchronize with the laparoscopic view and precisely determine the tumour location for optimal gastric resections. This allows the gastrectomy to be performed safely and prevents inadequate resection leaving tumour cells behind. This video is aimed at sharing our experience in performing pylorus-preserving gastrectomy.
00:00:01 Introduction
00:00:10 Case summary
00:00:23 Radiology: X-ray
00:00:30 Radiology: staging CT scan (snapshot)
00:00:38 Schematic diagram for PPG (gastric resection & lymph node dissection)
00:00:45 Laparoscopic assessment and liver retraction
00:00:51 Marking of important anatomical landmarks
00:01:16 Beginning of dissection over greater curvature: partial omentectomy
00:01:44 Intra-operative gastroscopy
00:02:45 Take down of the left gastro-epiploic vessels
00:03:32 Dissection of intra-pyloric region
00:04:35 Infra-pyloric artery preservation and right gastro epiploic vessel dissection
00:06:37 Supra-pyloric dissection
00:07:16 Distal gastric transection
00:07:57 Take-down of the left gastric artery and vein pedicle
00:08:45 Dissection of proximal lesser curvature
00:09:13 Proximal gastric transection
00:09:39 Gastro-gastrostomy reconstruction
00:12:48 Irrigation of the peritoneal cavity
00:12:53 Resected gastric specimen
00:12:58 Final pathology report

Disclosure

Hyuk-Joon Lee is the president of the Korean Surgical Skill Study Group and Seong-Ho Kong is an editorial board member of the journal, but they were not involved in the peer reviewer selection, evaluation, or decision process of this article. No other potential conflicts of interest relevant to this article were reported.

  • 1. Oh SY, Lee HJ, Yang HK. Pylorus-preserving gastrectomy for gastric cancer. J Gastric Cancer. 2016;16:63-71.ArticlePubMedPMCPDF
  • 2. Sun KK, Wu YY. Pylorus-preserving gastrectomy for early gastric cancer. World J Gastrointest Oncol. 2024;16:653-658.ArticlePubMedPMC
  • 3. Kong SH, Kim JW, Lee HJ, Kim WH, Lee KU, Yang HK. The safety of the dissection of lymph node stations 5 and 6 in pylorus-preserving gastrectomy. Ann Surg Oncol. 2009;16:3252-3258.ArticlePubMedPDF
  • 4. Park DJ, Kim YW, Yang HK, Ryu KW, Han SU, Kim HH, et al. Short-term outcomes of a multicentre randomized clinical trial comparing laparoscopic pylorus-preserving gastrectomy with laparoscopic distal gastrectomy for gastric cancer (the KLASS-04 trial). Br J Surg. 2021;108:1043-1049.ArticlePubMedPDF
  • 5. Xia X, Xu J, Zhu C, Cao H, Yu F, Zhao G. Objective evaluation of clinical outcomes of laparoscopy-assisted pylorus-preserving gastrectomy for middle-third early gastric cancer. BMC Cancer. 2019;19:481.ArticlePubMedPMCPDF
  • 6. Japanese Gastric Cancer Association. Japanese Gastric Cancer Treatment Guidelines 2021 (6th edition). Gastric Cancer. 2023;26:1-25.ArticlePubMedPMCPDF
  • 7. Kim TH, Kim IH, Kang SJ, Choi M, Kim BH, Eom BW, et al. Korean practice guidelines for gastric cancer 2022: an evidence-based, multidisciplinary approach. J Gastric Cancer. 2023;23:3-106.ArticlePubMedPMC

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        Laparoscopic Pylorus Preserving Gastrectomy with Intra-Corporeal Gastro-Gastrostomy Guided by Intra-Operative Gastroscopy
        J Surg Innov Educ. 2024;1(1):28-29.   Published online June 25, 2024
        DOI: https://doi.org/10.69474/jsie.2024.00059
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      Laparoscopic Pylorus Preserving Gastrectomy with Intra-Corporeal Gastro-Gastrostomy Guided by Intra-Operative Gastroscopy
      Laparoscopic Pylorus Preserving Gastrectomy with Intra-Corporeal Gastro-Gastrostomy Guided by Intra-Operative Gastroscopy
      JSIE : Journal of Surgical Innovation and Education
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