Endogia 60 mm reload with tri staple technology

Under general and epidural anaesthesia, LDG was performed with 5 ports (two 12-mm trocars and three 5-mm trocars). After lymph node dissection and incision of the duodenum, the C-arm (OEC 9900 Elite, GE Healthcare UK Ltd, Little Chalfont, Buckinghamshire, England) was positioned as shown in Figure 2. Surgeons, nurses, and anaesthesiologists were shielded with protectors. The proximal gastric incision line was marked with 1% Crystal violet on the serosal surface of the stomach, with the aid of clips under fluoroscopic guidance, followed by incision with a linear stapling device (Endo GIA™ 60 mm Reload with Tri-Staple™ Technology, Medtronic plc, Dublin, Ireland), using 2 or 3 cartridges from the left lower port [Figures 3 and 4]. After removal of the stomach through the small umbilical incision and confirming that all clips were included in the resected stomach [Figure 5], intracorporeal gastrointestinal reconstruction was performed. Billroth I (B-I) or Roux-en-Y (R-Y) method was selected, depending on the size of the remnant stomach. As for R-Y reconstruction, jejunojejunostomy was performed extracorporeally through the small umbilical incision. D1+ lymph node dissection was done, according to the Japanese guideline for gastric cancer.[6 ]