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 UNUSUAL CASE
Year : 2013  |  Volume : 9  |  Issue : 2  |  Page : 87-90

Single port Billroth I gastrectomy


Regional Oesophago-gastric Unit, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX, United Kingdom

Correspondence Address:
Yuen Soon
Regional Oesophago-gastric Unit, Royal Surrey County Hospital, Egerton Road, Guildford, Surrey, GU2 7XX
United Kingdom
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0972-9941.110971

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Introduction: Experience has allowed increasingly complex procedures to be undertaken by single port surgery. We describe a technique for single port Billroth I gastrectomy with a hand-sewn intracorporeal anastomosis in the resection of a benign tumour diagnosed incidentally on a background of cholelithiasis. Materials and Methods: Single port Billroth I gastrectomy and cholecystectomy was performed using a transumbilical quadport. Flexible tipped camera and straight conventional instruments were used throughout the procedure. The stomach was mobilised including a limited lymph node dissection and resection margins in the proximal antrum and duodenum were divided with a flexible tipped laparoscopic stapler. The lesser curve was reconstructed and an intracorporal hand sewn two layer end-to-end anastomosis was performed using unidirectional barbed sutures. Intraoperative endoscopy confirmed the anastomosis to be patent without leak. Results: Enteral feed was started on the day of surgery, increasing to a full diet by day 6. Analgesic requirements were a patient-controlled analgesia morphine pump for 4 postoperative days and paracetamol for 6 days. There were no postoperative complications and the patient was discharged on the eighth day. Histology confirmed gastric submucosal lipoma. Discussion: As technology improves more complex procedures are possible by single port laparoscopic surgery. In this case, flexible tipped cameras and unidirectional barbed sutures have facilitated an intracorporal hand-sewn two layer end-to-end anastomosis. Experience will allow such techniques to become mainstream.






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