• Kyoichi Takaori, Eiji Nomura, Hideaki Mabuchi, San-Woong Lee, Tomoyuki Agui, Yoshiharu Miyamoto, Mitsuhiko Iwamoto, Hisashi Watanabe, and Nobuhiko Tanigawa.
• Department of General and Gastroenterological Surgery, Osaka Medical College, 2-7 Daigakumachi, Takatsuki, Osaka 569-8686, Japan. sur098@poh.osaka-med.ac.jp
• Am. J. Surg. 2005 Feb 1;189(2):178-83.

BackgroundLaparoscopic distal gastrectomy [LDG] is a minimally invasive surgery for gastric carcinoma. The Billroth I method has been commonly employed to reconstruct alimentary tract after LDG. Conversely, Roux-Y reconstruction is employed far less commonly despite its merits. Technical difficulties, including a risk of twisting the Roux loop under limited vision through a laparoscope, have hampered Roux-Y reconstruction after LDG.MethodsWe performed LDG and intracorporeal Roux-Y reconstruction in 5 patients with early gastric cancer. The procedure included a functional end-to-end anastmosis of the stomach and jejunum, consisting of side-to-side approximation of jejunal loop to greater curvature of the gastric remnant with a laparoscopic stapling device followed by closure of the open end and simultaneous division of the jejunum with another stapler.ResultsRoux-Y reconstruction was successfully accomplished without torsion of the loop in all patients.ConclusionsBy using the present technique, intracorporeal Roux-Y reconstruction after LDG can be accomplished without a risk of twisting the jejunal loop.

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