Delta-shaped anastomosis in totally robotic Billroth I gastrectomy: technical aspects and short-term outcomes

Kenji Kikuchi, Koichi Suda, Masaya Nakauchi, Susumu Shibasaki, Kenichi Nakamura, Shuhei Kajiwara, Ai Goto, Kazuki Inaba, Yoshinori Ishida, Ichiro Uyama

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

INTRODUCTION: Delta-shaped anastomosis has been recognized as a method of intracorporeal Billroth I anastomosis in totally laparoscopic distal gastrectomy. However, the technical aspects and outcomes of the delta-shaped anastomosis in totally robotic distal gastrectomy have never been reported.

METHODS: A single-institutional, non-randomized, retrospective study was performed between 2009 and 2013. During the study period, 47 patients underwent robotic distal gastrectomy followed by robotic delta-shaped Billroth I reconstruction, and 165 patients underwent conventional laparoscopic distal gastrectomy followed by laparoscopic delta-shaped Billroth I reconstruction. After 64 were excluded because of insufficient intraoperative video, 43 patients in the robotic group and 105 patients in the laparoscopic group were enrolled in the study. Short-term outcomes were determined from medical records and full-length operative videos.

RESULTS: There were no significant differences between the robotic and laparoscopic groups in terms of morbidity (4.7% vs 3.8%), anastomosis-related complications (0% vs 1.0%), non-anastomosis-related complications (2.3% vs 0%), or systemic complications (2.3% vs 0%). Time for reconstruction did not vary between the robotic group (16.6 min [8.8-42.9 min]) and the laparoscopic group (15.8 min [7.2-41.0 min]). There was no mortality in this series. In the conventional group, the morbidity rate was 3.8%. The anastomosis-related complication rate was 1.0% in the conventional group.

CONCLUSIONS: Given the excellent short-term outcomes related to anastomosis, delta-shaped anastomosis after robotic distal gastrectomy was at least as feasible and safe as delta-shaped anastomosis after laparoscopic distal gastrectomy.

Original languageEnglish
Pages (from-to)250-257
Number of pages8
JournalAsian journal of endoscopic surgery
Volume9
Issue number4
DOIs
Publication statusPublished - 2016 Nov 1
Externally publishedYes

Keywords

  • Billroth-I reconstruction
  • delta-shaped anastomosis
  • robotic gastrectomy

ASJC Scopus subject areas

  • Medicine(all)

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    Kikuchi, K., Suda, K., Nakauchi, M., Shibasaki, S., Nakamura, K., Kajiwara, S., Goto, A., Inaba, K., Ishida, Y., & Uyama, I. (2016). Delta-shaped anastomosis in totally robotic Billroth I gastrectomy: technical aspects and short-term outcomes. Asian journal of endoscopic surgery, 9(4), 250-257. https://doi.org/10.1111/ases.12288