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Erschienen in: Surgical Endoscopy 6/2017

03.10.2016 | New Technology

Modified overlap method using knotless barbed sutures (MOBS) for intracorporeal esophagojejunostomy after totally laparoscopic gastrectomy

verfasst von: Sang-Yong Son, Long-Hai Cui, Ho-Jung Shin, Cheulsu Byun, Hoon Hur, Sang-Uk Han, Yong Kwan Cho

Erschienen in: Surgical Endoscopy | Ausgabe 6/2017

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Abstract

Background

Compared to end-to-side anastomosis with a circular stapler, the overlap method is favored for intracorporeal esophagojejunostomy because it facilitates handling of the stapler, even in narrow spaces, and wider anastomosis. However, it associates with technical difficulties during anastomosis, including difficult traction on the esophageal stump that necessitates stay sutures. Here, we introduce a new modified overlap method that employs knotless barbed sutures (MOBS) and report the outcomes of our case series.

Method

All consecutive patients who underwent intracorporeal esophagojejunostomy in 2015–2016 were included. All patients underwent surgery as follows: After esophageal transection with a linear stapler, two V-loc 90 sutures (Covidien, Mansfield, MA, USA) were sutured in the center of the stapled line. The opening was made between the two threads, and the intraluminal space was identified. The jejunum was ascended toward the esophageal stump by inserting a 45-mm-long linear staple. The anastomosis was made at the space between the right and left crura. After firing the linear stapler, the entry hole was closed bidirectionally using the pre-sutured threads.

Results

Forty patients underwent MOBS (27 by laparoscopy; 13 by robot). Mean total operative and MOBS procedural times were 180.6 and 22.4 min, respectively. Mean hospital stay was 6.9 days. Two patients had major complications (5.0 %). There were no anastomosis-related complications. Laparoscopy and robot subgroups did not differ in mean MOBS procedural times (22.2 vs. 22.7 min, p = 0.787).

Conclusion

MOBS is a safe and feasible method that is a good option for intracorporeal esophagojejunostomy after laparoscopic gastrectomy.
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Metadaten
Titel
Modified overlap method using knotless barbed sutures (MOBS) for intracorporeal esophagojejunostomy after totally laparoscopic gastrectomy
verfasst von
Sang-Yong Son
Long-Hai Cui
Ho-Jung Shin
Cheulsu Byun
Hoon Hur
Sang-Uk Han
Yong Kwan Cho
Publikationsdatum
03.10.2016
Verlag
Springer US
Erschienen in
Surgical Endoscopy / Ausgabe 6/2017
Print ISSN: 0930-2794
Elektronische ISSN: 1432-2218
DOI
https://doi.org/10.1007/s00464-016-5269-z

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