Total laparoscopic gastrectomy with D2 lymphadenectomy

Anatomy Perioperative management Technique Complications Evidence Total Video Medical Equipment

Content

Trocar positioning
Incising the gastrocolic ligament and resecting the omentum (LN 4)
Dissecting the duodenum (LN 11) and transecting the right gastric artery
Dissecting the common hepatic artery, resecting the lesser omentum and transecting the duodenum
Exposing the celiac trunk (LN 8), dissecting and dividing the left gastric artery
Dissecting the splenic hilum (LN 10)
Dissecting the esophageal hiatus, including lymphadenectomy down to the aorta (LN 1 and 2)
Temporarily anchoring the jejunum on the stomach, Roux-en-Y jejunostomy
Opening the esophagus and placing the CEEA anvil through the mouth
End-to-side esophagojejunostomy
Completing the Roux-en-Y anastomosis with jejunal segment resection
Oversewing esophagojejunostomy suture line failure
Retrieving the resected gastric specimen, drainage
Resected gastric specimen

Authors

Prof. Dr. med. Markus Heiss

Krankenhaus Merheim

Date

date of publication: 22.02.2015
date of update: 10.09.2023

Trocar positioning
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Start the procedure by marking the trocar positions on the abdominal wall. After inserting the Veress needle and pressure-controlled CO2 insufflation, place the following trocars in a semicircle:
- T1 = camera trocar (10 mm)
  T2 = working trocar(10 mm)
  T3 = working trocar 5 mm (later 12 mm for CEEA stapler and extension of incision for specimen retrieval)
  T4 = working trocar (12 mm)
  T5 = working trocar (5 mm)

Incising the gastrocolic ligament and resecting the omentum (LN 4)

Start the resection phase by opening the lesser peritoneal sac and incising the gastrocolic ligamen

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general and visceral surgery

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After activation, you can expect the following content:

Trocar positioning
Incising the gastrocolic ligament and resecting the omentum (LN 4)
Dissecting the duodenum (LN 11) and transecting the right gastric artery
Dissecting the common hepatic artery, resecting the lesser omentum and transecting the duodenum
Exposing the celiac trunk (LN 8), dissecting and dividing the left gastric artery
Dissecting the splenic hilum (LN 10)
Dissecting the esophageal hiatus, including lymphadenectomy down to the aorta (LN 1 and 2)
Temporarily anchoring the jejunum on the stomach, Roux-en-Y jejunostomy
Opening the esophagus and placing the CEEA anvil through the mouth
End-to-side esophagojejunostomy
Completing the Roux-en-Y anastomosis with jejunal segment resection
Oversewing esophagojejunostomy suture line failure
Retrieving the resected gastric specimen, drainage
Resected gastric specimen

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Activate now and continue learning straight away.

Single Access

Activation of this course for 3 days.

US$9.30 inclusive VAT

webop - Savings Flex

Combine our learning modules flexibly and save up to 50%.

from US$7.25 / module

US$87.02/ yearly payment

price overview

general and visceral surgery

Unlock all courses in this module.

US$14.50 / month

US$174.10 / yearly payment

After activation, you can expect the following content:

Trocar positioning
Incising the gastrocolic ligament and resecting the omentum (LN 4)
Dissecting the duodenum (LN 11) and transecting the right gastric artery
Dissecting the common hepatic artery, resecting the lesser omentum and transecting the duodenum
Exposing the celiac trunk (LN 8), dissecting and dividing the left gastric artery
Dissecting the splenic hilum (LN 10)
Dissecting the esophageal hiatus, including lymphadenectomy down to the aorta (LN 1 and 2)
Temporarily anchoring the jejunum on the stomach, Roux-en-Y jejunostomy
Opening the esophagus and placing the CEEA anvil through the mouth
End-to-side esophagojejunostomy
Completing the Roux-en-Y anastomosis with jejunal segment resection
Oversewing esophagojejunostomy suture line failure
Retrieving the resected gastric specimen, drainage
Resected gastric specimen

Total laparoscopic gastrectomy with D2 lymphadenectomy

Trocar positioning

Activate now and continue learning straight away.

Single Access

webop - Savings Flex

general and visceral surgery

Activate now and continue learning straight away.

Single Access

webop - Savings Flex

general and visceral surgery