Laparoscopic Hunt-Lawrence Jejunal Pouch for Reconstruction After Total Gastrectomy for Gastric Cancer. 2021

Caroline E Poorman, and Ankit D Patel, and S Scott Davis, and Edward Lin
Emory Endosurgery Unit, Division of General and GI Surgery, Department of Surgery, Emory University School of Medicine, Atlanta, Georgia, USA.

There are several reconstruction options described in the literature after total gastrectomy for gastric cancer. The most common laparoscopic jejunal pouch technique involves evisceration of the small bowel and extracorporeal pouch formation. We describe a completely intracorporeal technique for the Hunt-Lawrence J-pouch Roux-en-Y reconstruction. After gastrectomy and formation of the Roux limb, we create the esophagojejunal anastomosis using an end-to-end anastomosis (EEA) stapler threaded 6-7 cm into the Roux limb to leave a tail of jejunum for the pouch. Next we form the jejunal pouch with a linear stapler and close the common enterotomy with suture or stapler. Our technique offers a streamlined and efficient approach to the Hunt-Lawrence reconstruction and can be effectively performed both laparoscopically and robotically.

UI MeSH Term Description Entries
D007583 Jejunum The middle portion of the SMALL INTESTINE, between DUODENUM and ILEUM. It represents about 2/5 of the remaining portion of the small intestine below duodenum. Jejunums
D010535 Laparoscopy A procedure in which a laparoscope (LAPAROSCOPES) is inserted through a small incision near the navel to examine the abdominal and pelvic organs in the PERITONEAL CAVITY. If appropriate, biopsy or surgery can be performed during laparoscopy. Celioscopy,Laparoscopic Surgical Procedures,Peritoneoscopy,Surgical Procedures, Laparoscopic,Laparoscopic Assisted Surgery,Laparoscopic Surgery,Laparoscopic Surgical Procedure,Procedure, Laparoscopic Surgical,Procedures, Laparoscopic Surgical,Surgery, Laparoscopic,Surgical Procedure, Laparoscopic,Celioscopies,Laparoscopic Assisted Surgeries,Laparoscopic Surgeries,Laparoscopies,Peritoneoscopies,Surgeries, Laparoscopic,Surgeries, Laparoscopic Assisted,Surgery, Laparoscopic Assisted
D005743 Gastrectomy Excision of the whole (total gastrectomy) or part (subtotal gastrectomy, partial gastrectomy, gastric resection) of the stomach. (Dorland, 28th ed) Gastrectomies
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000713 Anastomosis, Roux-en-Y A Y-shaped surgical anastomosis of any part of the digestive system which includes the small intestine as the eventual drainage site. Roux-en-Y Anastomosis,Roux-en-Y Diversion,Roux-en-Y Loop,Anastomoses, Roux-en-Y,Anastomosis, Roux en Y,Diversion, Roux-en-Y,Diversions, Roux-en-Y,Loop, Roux-en-Y,Loops, Roux-en-Y,Roux en Y Anastomosis,Roux en Y Diversion,Roux en Y Loop,Roux-en-Y Anastomoses,Roux-en-Y Diversions,Roux-en-Y Loops
D013274 Stomach Neoplasms Tumors or cancer of the STOMACH. Cancer of Stomach,Gastric Cancer,Gastric Neoplasms,Stomach Cancer,Cancer of the Stomach,Gastric Cancer, Familial Diffuse,Neoplasms, Gastric,Neoplasms, Stomach,Cancer, Gastric,Cancer, Stomach,Cancers, Gastric,Cancers, Stomach,Gastric Cancers,Gastric Neoplasm,Neoplasm, Gastric,Neoplasm, Stomach,Stomach Cancers,Stomach Neoplasm

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