Totally laparoscopic stapled anastomosis after distal gastrectomy

There is wide variation in technique for anastomosis in laparoscopic gastrectomy. Du et al. report a novel stapled method for gastrojejunal using a circular stapler, applied in 34 patients. Compared to an intracorporeal handsewn anastomosis, this technique was equally effective and safe, but required less operative time (239 vs. 203.6 minutes). Whilst laparoscopic distal gastrectomy is undertaken commonly in some Asian countries, Western surgeons deal with a smaller gastric cancer case load, and face significant challenges if considering this approach for their practices.