A new technique for esophagojejunostomy or esophagogastrostomy after laparoscopic gastrectomy

Objective To report the newly developed reconstruction technique after laparoscopic total gastrectomy:intracorporeal circular stapling esophagojejunostomy using the transorally inserted anvil (OrVil~(TM);Covidien),and evaluate its feasibility,safety,and clinical outcomes.Methods After LTG (3 patients with gastric carcinoma in the body) or LPG(2 patients with gastric carcinoma in the cardiac and fundus,respectively,and 1 with cardiac stromal tumor),the anvil was then inserted transorally into the esophagus by using the OrVil~(TM) system.Double-stapling esophagojejunostomy or esophagogastrostomy with a circular stapler was performed intracorporeally.Results The operations were uneventful The operative time was (183.3±25.8) min,and blood loss was (128.3±90.2) ml.Postoperative fluorography revealed no anastomotic leakage or stenosis.Patients resumed an oral liquid diet on postoperative day (4.0±1.1),and were discharged on day (9.0±2.6).Patients were followed at 28 days and no complications were reported.Conclusions LTG with Roux-en-Y reconstruction or LPG with esophagogastrostomy using the OrVil~(TM) system appear to be safe and reliable with satisfactory shortterm outcomes. Key words: Stomach neoplasms;  Laparoscopic surgery;  Gastrectomy;  Esophagojejunostomy;  Esophagogastrostomy