Partial gastrectomy with Roux-en-Y gastrojejunostomy

Anatomy Perioperative management Technique Complications Evidence Total Video Medical Equipment

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Freeing the greater omentum and transecting the gastroepiploic vessels
Lymphadenectomy I (hepatoduodenal ligament/LN stations 12 and 13)
Lymphadenectomy II (common hepatic artery/station 8)
Lymphadenectomy III (celiac trunk/station 9)
Gastric resection
Transecting the duodenum
Taking down adhesions with the pancreas and removing the specimen
Closing the mesocolic window, Lembert sutures of the staple lines
Preparing the Roux-en-Y limb
End-to-side gastrojejunostomy, antecolic: Suturing the posterior wall I
End-to-side gastrojejunostomy, antecolic: Suturing the posterior wall II
End-to-side gastrojejunostomy, antecolic: Suturing the anterior wall I
End-to-side gastrojejunostomy, antecolic: Suturing the anterior wall II
End-to-side jejunojejunostomy ("Roux-en-Y reconstruction") I
End-to-side jejunojejunostomy ("Roux-en-Y reconstruction") II
Closing the abdominal wall

Authors

Prof. Dr. med. Markus Heiss

Krankenhaus Merheim

Date

date of publication: 15.08.2013

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Open the abdomen through an epigastric midline incision, with left periumbilical extension caudad After inserting the abdominal retractor system, explore the abdominal cavity and assess the location and extent of the primary tumor as well as any lymph node involvement and organ metastases.

Freeing the greater omentum and transecting the gastroepiploic vessels

Pull up the greater omentum and apply measured traction against the transverse colon. Dissect the g

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Freeing the greater omentum and transecting the gastroepiploic vessels
Lymphadenectomy I (hepatoduodenal ligament/LN stations 12 and 13)
Lymphadenectomy II (common hepatic artery/station 8)
Lymphadenectomy III (celiac trunk/station 9)
Gastric resection
Transecting the duodenum
Taking down adhesions with the pancreas and removing the specimen
Closing the mesocolic window, Lembert sutures of the staple lines
Preparing the Roux-en-Y limb
End-to-side gastrojejunostomy, antecolic: Suturing the posterior wall I
End-to-side gastrojejunostomy, antecolic: Suturing the posterior wall II
End-to-side gastrojejunostomy, antecolic: Suturing the anterior wall I
End-to-side gastrojejunostomy, antecolic: Suturing the anterior wall II
End-to-side jejunojejunostomy ("Roux-en-Y reconstruction") I
End-to-side jejunojejunostomy ("Roux-en-Y reconstruction") II
Closing the abdominal wall

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