Evaluation of Hand-Assisted Laparoscopic Distal Gastrectomy for Patients with Early Gastric Cancer

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  • 早期胃癌に対するＨａｎｄ－Ａｓｓｉｓｔｅｄ　Ｌａｐａｒｏｓｃｏｐｉｃ　Ｄｉｓｔａｌ　Ｇａｓｔｒｅｃｔｏｍｙの試み
  • ソウキ イガン ニ タイスル Hand Assisted Laparoscopic Distal Gastrectomy ノ ココロミ

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Abstract

Laparoscopy-assisted distal gastrectomy (LADG) has been advocated as a minimally invasive operation for early gastric cancer which needs regional lymph node resection. However, since it is technically too complicated and difficult to perform all laparoscopic procedures within the abdominal cavity, LADG has not become the standard surgical procedure for early gastric cancer. Moreover, a skin incision of approximately 5cm is required to allow the reconstruction of the digestive tract after gastrectomy. Therefore, we have developed an operative procedure which we call hand-assisted laparoscopic distal gastrectomy (HALDG). In this procedure we make a skin incision of 6cm, and the surgeon inserts his/her left hand into the abdomen to assist the laparoscopic procedure. The surgeon can move his/her left hand freely, to palpate and explore the organs, as in an open surgery. Therefore, the operation time can be shortened. Our results thus far obtained demonstrated that HALDG was as safe and effective as open distal gastrectomy. HALDG assures the patients a better quality of life, --less surgical trauma, less pain, speedy return to dialy life activities. Thus, it is beneficial to the patients with early gastric cancer. We, therefore, advocate the use of HALDG in such cases.

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