Minilaparotomy for early gastric cancer

BACKGROUND/AIMS: From the experience of laparoscopic-assisted distal gastrectomy, it was considered that a gastrectomy with lymph node dissection could be performed through a minilaparotomy, placed as for gastroduodenostomy in laparoscopic-assisted distal gastrectomy. METHODOLOGY: Ten patients with early gastric cancer underwent gastrectomy with lymph node dissection via minilaparotomy. Minilaparotomy was performed via a seven-centimeter midline incision placed at the mid-upper abdomen. Two six-centimeter-wide Kent retractors were used to suspend the abdominal wall on each side, and a multipurpose surgical arm to retract the liver. The abdominal wound could be moved horizontally by pulling these retractors to the right or left. This movable wound allowed direct visualization of almost all the operative field for gastrectomy. RESULTS: No operation was converted to a standard open gastrectomy. The patients who had a tumor in the lower third of the stomach underwent complete D2 lymph node dissection. In the patients who underwent pylorus-preserving gastrectomy, near complete D2 lymph node dissection was performed. Mean operation time was 175 minutes. No significant complication was encountered. CONCLUSIONS: It was concluded that minilaparotomy could be used as an alteration to the standard open gastrectomy.