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首页> 外文期刊>Surgical Endoscopy >Modified hemi-double-stapling technique combined with the temporal abdominal-wall-lift method for performing Billroth I anastomosis after laparoscopically assisted distal gastrectomy
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Modified hemi-double-stapling technique combined with the temporal abdominal-wall-lift method for performing Billroth I anastomosis after laparoscopically assisted distal gastrectomy

机译：改良半双吻合技术结合颞腹壁抬高法在腹腔镜辅助远端胃切除术后进行Billroth I吻合术

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The authors have used a modified hemi-double-stapling (HDS) technique for reconstruction after laparoscopically assisted distal gastrectomy. The stomach is resected from the greater curvature side using a linear stapler inserted into the stomach from that side at a position vertical to the line of the greater curvature. Resection of the stomach is performed by extending the resection line to the lesser curvature using laparoscopic coagulating shears. The resected specimen is examined. After placement of a purse-string suture at the duodenal stump, an anvil is inserted into the stump, and an additional suture with 2-0 silk is placed over the purse-string suture. A curved intraluminal stapler (CDH25) is inserted into the stomach through the opening made on the lesser curvature side, and the center rod of the stapler is passed through the gastric wall on the corner of the resection line at the greater curvature. Ligation with 2-0 silk is added to the center rod by suturing the gastric tissue 5-8 mm from the center rod to encircle it. The authors call this the "one-knot setup HDS," and with this method, a large-caliber anastomosis is secured. In many cases, it is difficult to observe the anastomotic site through the small incisional opening. However, under laparoscopy with the temporal abdominal wall-lift method using the Multi Flap Gate, the anastomotic site can be easily and safely observed. One-knot setup HDS combined with the temporal abdominal wall-lift method is considered a safe and simple method for performing Billroth I anastomosis in laparoscopic distal gastrectomy.
机译：作者已使用改良的半双吻合器（HDS）技术在腹腔镜辅助远端胃切除术后进行重建。使用线性订书机从那侧在垂直于大曲率线的位置处将其从大曲率侧切除胃。通过使用腹腔镜凝结剪将切除线延伸至较小的曲率来进行胃切除。检查切除的标本。在十二指肠残端放置一个荷包缝合线后，将一个砧座插入残端，并在荷包缝合线上放置一个附加的2-0丝线。弯曲的腔内吻合器（CDH25）通过曲率较小的开口插入胃中，吻合器的中心杆以较大曲率穿过切除线角处的胃壁。通过将胃组织从中心杆缝合5-8毫米以将其包围，将2-0丝结扎到中心杆上。作者称其为“单节点设置HDS”，并通过这种方法确保了大口径吻合。在许多情况下，很难通过小切口切开来观察吻合部位。但是，在腹腔镜下使用多瓣门的颞腹壁举起方法，可以轻松，安全地观察吻合部位。一结式HDS结合颞腹壁举升法被认为是在腹腔镜远端胃切除术中进行Billroth I吻合术的安全且简单的方法。

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