Intracorporeal laparoscopic esophagojejunostomy using endoscopic linear staplers: the experiences of 293 cases

Although several investigators have suggested their method to perform a totally laparoscopic total gastrectomy (TLTG), even experts on laparoscopic gastrectomy, it is very hard to perform a safe TLTG in practice because of the complexity of procedure. We developed a secure technique for intracorporeal laparoscopic esophagojejunostomy (EJ) using endoscopic linear staplers and successfully performed the TLTG method. Between September 2006 and January 2013, total of 293 patients with early gastric cancer in the upper third of the stomach underwent TLTG using endoscopic linear stapler in one institution. The laparoscopic EJ was successfully performed in all patients; none of the patients required conversion to open surgery or other laparoscopic anastomosis techniques. All the operations were curative. The intracorporeal EJ procedure can be performed easily and safely, and this method of TLTG may become a powerful alternative procedure for intracorporeal EJ after laparoscopic total gastrectomy.