Research article

Laparoscopic partial gastric transection and devascularization in order to enhance its flow

Federico Cuenca-Abente , Ahmad Assalia , Gianmattia del Genio , Tomasz Rogula , David Nocca , Kazuki Ueda and Michel Gagner

Division of Laparoscopic Surgery, Mount Sinai Minimally Invasive Surgery Center (MSMISC), Department of Surgery, Mount Sinai School of Medicine, New York, NY, USA

author email corresponding author email

Annals of Surgical Innovation and Research 2008, 2:3doi:10.1186/1750-1164-2-3

Published:	7 July 2008

Abstract

Background

Esophagogastric fistula following an esophagectomy for cancer is very common. One of the most important factors that leads to its development is gastric isquemia. We hypothesize that laparoscopic gastric devascularization and partial transection is a safe operation that will enhance the vascular flow of the fundus of the stomach.

Method

Our study included eight pigs. Each animal had two operations. In the first one, a laparoscopic gastric devascularization and mobilization took place. Vascular flow was measured previous to the procedure and immediately after it with a laser doppler (endoscopic probe). After three weeks, a second operation took place. We re-measured the vascular flow and sent a sample of gastric fundus for histopathologic evaluation.

Results

The gastric fundus showed signs of neovascularization after both macroscopic and microscopic evaluation. These findings correlated with laser doppler measurements.

Conclusion

Laparoscopic gastric devascularization and partial transection is a safe procedure that increases the vascular flow of the stomach in a three week period. This finding can have a positive impact in terms of decreasing fistula formation.