Total gastrectomy for early gastric cancer and giant paraesophageal hernia
Epublication WebSurg.com, Jan 2014;14(01). URL: http://websurg.com/doi/vd01en4138
This video shows a total gastrectomy in an 83-year-old woman with a giant type III paraesophageal hernia and an early gastric cancer located at the middle third of the stomach. First, type III paraesophageal hernia dissection with complete resection of the hernia sac is shown. A D1 lymphadenectomy is performed. The esophagus is transected high in the posterior mediastinum and an end-to-side esophago-jejunostomy is performed using the Orvil™ orogastric tube and the EEA™ DST XL 25 circular stapling device. The esophago-jejunostomy is performed in a Roux-en-Y fashion. The alimentary limb is ascended through the transverse mesocolon. The skin incision used for trocar placement in the upper left abdomen (right hand of the surgeon) was slightly enlarged to allow for specimen extraction. Through this incision, the side-to-side jejuno-jejunostomy was performed extracorporeally.