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Totally laparoscopic gastrectomy and D2 lymphadenectomy with repair of a positive leak test

Epublication WebSurg.com, Feb 2016;16(02). URL: http://websurg.com/doi/vd01en4679

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  • 2016-02-02
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The objective of this video is to demonstrate a laparoscopic total gastrectomy with D2 lymphadenectomy for antral gastric cancer. The patient we present is a 40 year-old gentleman who presented with epigastric pain. Endoscopy revealed a neoplastic lesion at the gastric antrum. Biopsies confirmed the presence of an adenocarcinoma. This was staged as a T2 lesion and there was no distant metastasis. A total gastrectomy was planned using a total laparoscopic approach. For reconstruction, the authors used a Roux En Y esophagojejunal anastomosis using the transoral delivery of the OrVil® device (Covidien, Mansfield, MA, USA). We also demonstrate how to deal with a positive intraoperative leak test at the end of the procedure.