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Double-loop reconstruction after laparoscopic gastrectomy for gastric cancer
Alessio Giordano, Rosina Giudicissi, Samantha Vellei, Stefano Cantafio
Department of Surgery, General Surgery Unit, “S.Stephen” New Hospital, Prato, Italy
Correspondence Address:
Alessio Giordano,
Department of Surgery, General Surgery Unit, “S.Stephen” New Hospital, Via Suor Niccolina Infermiera 20/22, Prato 59100
Italy
 Source of Support: None, Conflict of Interest: None DOI: 10.4103/jmas.jmas_39_22
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Gastric cancer (GC) constitutes a major health problem. In addition to the popularity of laparoscopic gastrectomy, many reconstructive procedures have been reported in the literature. Surgical resection and lymphatic dissection determine long-term survival; however, the election of a reconstruction procedure determines the postoperative quality of life for patients with GC. At present, no consensus exists regarding the optimal reconstructive procedure. A new reconstructive approach was recently adopted at our center. Laparoscopic distal or total gastrectomy with D2 lymphadenectomy and a so called 'double-loop' reconstruction method with intracorporeal mechanical anastomosis was performed in our patients and we describe the technical note and outcome. The intuition in its use comes from the packaging of gastric bypasses in bariatric surgery. The double-loop method is a valid simplification of the traditional technique of construction of the Roux-limb that could increase the feasibility and safety in performing a full laparoscopic intracorporeal reconstruction with greater ergonomics for the surgeon.
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