Application of the transorally inserted anvil (OrVil) after laparoscopy-assisted total gastrectomy.

Kunisaki, Chikara; Makino, Hirochika; Oshima, Takashi; Fujii, Shoichi; Kimura, Jun; Takagawa, Ryo; Kosaka, Takashi; Akiyama, Hirotoshi; Morita, Satoshi; Endo, Itaru

BACKGROUND Laparoscopy-assisted total gastrectomy (LATG) is not a commonly performed procedure due to the surgical difficulty associated with reconstruction. Although various reconstruction methods have been reported, a standard technique has not yet been established. In this study, we compared the short-term outcomes of LATG reconstructed by mini-laparotomy and by the newly developed transorally inserted anvil (OrVil). METHODS From April 2006, a series of 45 patients underwent LATG. Of these, 15 were reconstructed by mini-laparotomy and 30 by OrVil. Short-term outcomes were compared between the two groups. RESULTS Operation time was significantly shortened and intraoperative blood loss significantly reduced by the use of OrVil. The postoperative course, including morbidity, did not differ between the two groups. CONCLUSIONS LATG using OrVil for the treatment of early gastric cancer is a technically feasible surgical procedure with sufficient lymph node dissection, satisfactory early recovery, and acceptable morbidity. It will be necessary to perform this novel technique in a large number of patients to confirm its feasibility.