Delta-shaped anastomosis in totally laparoscopic Billroth I gastrectomy: new technique of intraabdominal gastroduodenostomy.

Recently, laparoscopic gastrectomy has become popular for the treatment of benign gastroduodenal diseases or early gastric carcinomas. Several procedures can now be performed intraabdominally because of advances in technology and surgical techniques, but Billroth I reconstruction after laparoscopic distal gastrectomy is commonly performed extraabdominally because of the complexity of intraabdominal anastomotic procedure. We have developed a new method of intraabdominal Billroth I anastomosis using only endoscopic linear staplers. Our procedure is simple, easy, and safe. In this article, we describe the technique and present the results of our initial trials.