Case Report: Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy for gastric cancer in a patient with situs inversus totalis: with video

Frontiers in Oncology

Oncology

Zheng Liu¹  Xishan Wang¹  Zeyu Li²  Ruiting Liu²  Jian Qiu²  Xiaolong Zhang²  Lifei Tian²  Likun Yan²  Guorong Wang²  Xiaoqiang Wang²  Xinhua Liao³ 

[1] Department of Colorectal Surgery, National Cancer Center/National Clinical Research Center for Cancer/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China;Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an, Shaanxi, China;Department of General Surgery, The First Affiliated Hospital of Xi’an Jiaotong University, Xi’an, Shaanxi, China;

关键词: situs inversus totalis;    gastric cancer;    natural orifice specimen extraction surgery;    laparoscope;    minimally invasive;   

DOI  :  10.3389/fonc.2023.1189948

 received in 2023-03-28, accepted in 2023-05-09,  发布年份 2023

来源: Frontiers

【 摘 要 】

Because of its significant advantage of fast postoperative recovery, natural orifice specimen extraction surgery (NOSES) has attracted increasing attention worldwide. However, the NOSES in gastric cancer (GC) treatment still needs more clinical practice, especially for the rare anatomical anomaly. Situs inversus totalis (SIT) is a rare autosomal recessive anatomical anomaly with an incidence ranging between 1/8,000 and 1/25,000 births. We present a video of transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy performed in a 59-year-old woman known to have SIT. Preoperative investigations revealed that the patient had early GC at the antrum. A gastroscopy report from the local hospital showed signet-ring cell carcinoma. The preoperative computed tomography scan revealed irregular thickening of the gastric wall at the junction of the greater curvature and antrum without metastasis to the lymph nodes. In total, laparoscopic D2 distal gastrectomy was performed with transvaginal specimen extraction. Billroth II with Braun anastomosis was performed for reconstruction. The length of the operation was 240 min without intraoperative complications and with minimal blood loss of 50 ml. The patient was uneventfully discharged on postoperative Day 7. The final pathology confirmed signet-ring cell carcinoma confined to the mucosal muscle without metastasis in 16 lymph nodes. Transvaginal specimen extraction following totally laparoscopic D2 distal gastrectomy can be safely performed in patients with SIT and has similar surgical outcomes to usual laparoscopic gastrectomy.

【 授权许可】

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Copyright © 2023 Li, Zhang, Tian, Liu, Liao, Qiu, Wang, Yan, Wang, Wang and Liu