Inguinal Hernia Orifice for Specimen Extraction After Laparoscopic Resections

ROBOTIC GASTRECTOMY: TECHNIQUE STANDARDIZATION

BACKGROUND

Trocars position for the Si model (position is similar for the Xi, although trocars stay more in line). Robotic gastrectomy is gaining popularity worldwide. It allows reduced blood loss and lesser pain. However, it widespread use is limited by the extensive learning curve and costs.

AIM

To describe our standard technique with reduced use of robotic instruments.

METHODS

We detail the steps involved in the procedure, including trocar placement, necessary robotic instruments, and meticulous surgical description.

RESULTS

After standardizing the procedure, 28 patients were operated with this budget technique. For each procedure material used was: 1 (Xi model) or 2 disposable trocars (Si) and 4 robotic instruments. Stapling and clipping were performed by the assistant through an auxiliary port, limiting the use of robotic instruments and reducing the cost.

CONCLUSION

This standardization helps implementing a robotic program for gastrectomy in the daily practice or in one`s institution.

Laparoscopic D2 Gastrectomy for Gastric Cancer: Mid-Term Results and Current Evidence

INTRODUCTION

Although the first laparoscopic gastrectomy was performed in 1991, there was a long delay until it was incorporated into the regular practice of western surgeons. In Brazil, there are only few case series reported and data on its safety and efficacy along with mid- and long-term results are desired.

OBJECTIVE

Present the mid-term results of laparoscopic gastrectomy with curative intent in the treatment of gastric adenocarcinoma and review the current evidence on the therapy of this neoplasia with the laparoscopic access.

METHODS

Patients who underwent D2 laparoscopic gastrectomy for gastric adenocarcinoma were retrospectively reviewed.

RESULTS

Sixty-nine patients met the inclusion criteria. The mean age was 59.2 years and the mean body mass index was 24.2 kg/m². Subtotal gastrectomy was performed in 73.9%. The mean number of harvested lymph nodes was 36.7, increased lymph node count and shorter operative time were observed in the last 34 cases. Median hospital stay was 8 days. Postoperative complications occurred in 22 (31.9%) cases. Surgical mortality was 4.3%.

CONCLUSION

Laparoscopic gastrectomy can be performed safely with excellent short- and mid-term results. As experience increases, surgical duration is reduced and lymph node count rises.