Laparoscopic synchronous distal gastrectomy and sigmoid colectomy for double cancer with transvaginal specimen extraction Naoki YAGI 1 , Naoki TOMIZAWA 1 , Takuhisa OKADA 1 , Takuya SHIRAISHI 1 , Marie HOSHINO 1 , Tatsumasa ANDOH 1 1Department of Surgery, Japanese Red Cross Maebashi Hospital Keyword: 腹腔鏡下手術 , 経腟的標本摘出 , 重複癌 pp.625-631
Published Date 2017/9/15
DOI https://doi.org/10.11477/mf.4426200452
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We performed a complete laparoscopic surgery with transvaginal specimen extraction in order to further minimize surgical invasiveness. We believe that transvaginal specimen extraction is a more cosmetic, less painful, and less invasive method. The patient was a 76-year-old female who underwent colonoscopy to evaluate anemia and gastroenteroscopy for preoperative screening. The results showed a type 2 lesion in the sigmoid colon and a 0-Ⅱc lesion in the gastric antrum. Operation was performed by inserting a 12-mm-diameter port through the umbilicus under open method. Five ports were made in the form of a reverse trapezoid to permit distal gastrectomy. Lymph node dissection was performed prior to gastrectomy to prevent any specimen degradation that might be caused by ischemia. After addition of a 5-mm-diameter port through the right inferior abdomen, laparoscopic sigmoid colectomy and gastrectomy followed by transvaginal specimen extraction were performed. The colon was anastomosed using a double-stapling technique. A functional gastrojejuno end-to-end anastomosis using an automatic suturing device was created and side-to-side Y-limb anastomosis employing a circular stapler was performed. After anastomosis, the posterior vaginal fornix was closed with a V-lock, commencing at the vagina. The patient was discharged on postoperative day 11. We report a patient with double cancer treated via synchronous laparoscopic distal gastrectomy and sigmoid colectomy, featuring transvaginal specimen extraction. A literature review is added.

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