Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach

Masashi Hirota, Kiyokazu Nakajima, Yoshihito Souma, Syoki Mikata, Kazuhiro Iwase, Koichi Demura, Tsuyoshi Takahashi, Makoto Yamasaki, Hiroshi Miyata, Yukinori Kurokawa, Shuji Takiguchi, Masaki Mori, Yuichiro Doki

Research output: Contribution to journalArticle

Abstract

Background: Intra-thoracic stomach (ITS) is a rare type of hiatal hernia. Laparoscopic surgery for ITS is technically demanding due to the distorted surgical anatomy. We incorporated assistive esophagoscopy during laparoscopic surgery for ITS. In this study, we assessed the clinical value of esophagoscopy in laparoscopic surgery. Methods: A retrospective data analysis of 11 consecutive patients with ITS was conducted. Laparoscopic surgery was conducted using a standard five-port technique, with the combination of carbon dioxide insufflating flexible esophagoscopy. The main indications for esophagoscopy were, (1) to demonstrate the course of esophagus and stomach during trans-hiatal mediastinal dissection, (2) to identify important anatomic landmarks, e.g., esophago-gastric junction, and (3) to calibrate the esophageal lumen during cruroplasty and/or fundoplication. Data included patient demographics, types of procedures, rate of conversion and/or complications, and surgical outcome. Results: Among 11 patients (9 females, 2 males, median age 75 years), 6 had gastric volvulus. Laparoscopic reduction of ITS with cruroplasty was completed in all cases without intraoperative complications. Six cases required prosthesis. Concomitant procedures were Nissen fundoplication in 9, Collis gastroplasty in 2, and sutured gastropexy in 5 cases. Flexible esophagoscopy enhanced the conduct and completion of these procedures, without any endoscopy-related complications. The median operation time was 247 min, and blood loss was minimal. The postoperative course was uneventful except for transient postoperative dysphagia in 2 cases. No relapse was noted within a median follow-up period of 11 months. Conclusions: Assistive intraoperative esophagoscopy facilitated laparoscopic surgery for ITS, suggesting it could potentially improve the surgical outcome by providing a better view during surgery.

Original languageEnglish
Pages (from-to)70-78
Number of pages9
JournalEsophagus
Volume10
Issue number2
DOIs
Publication statusPublished - Jun 1 2013

Fingerprint

Esophagoscopy
Laparoscopy
Stomach
Thorax
Fundoplication
Gastropexy
Stomach Volvulus
Anatomic Landmarks
Gastroplasty
Hiatal Hernia
Intraoperative Complications
Deglutition Disorders
Carbon Dioxide
Esophagus
Endoscopy
Prostheses and Implants
Dissection
Anatomy
Demography
Recurrence

All Science Journal Classification (ASJC) codes

  • Gastroenterology

Cite this

Hirota, M., Nakajima, K., Souma, Y., Mikata, S., Iwase, K., Demura, K., ... Doki, Y. (2013). Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach. Esophagus, 10(2), 70-78. https://doi.org/10.1007/s10388-013-0367-7

Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach. / Hirota, Masashi; Nakajima, Kiyokazu; Souma, Yoshihito; Mikata, Syoki; Iwase, Kazuhiro; Demura, Koichi; Takahashi, Tsuyoshi; Yamasaki, Makoto; Miyata, Hiroshi; Kurokawa, Yukinori; Takiguchi, Shuji; Mori, Masaki; Doki, Yuichiro.

In: Esophagus, Vol. 10, No. 2, 01.06.2013, p. 70-78.

Research output: Contribution to journalArticle

Hirota, M, Nakajima, K, Souma, Y, Mikata, S, Iwase, K, Demura, K, Takahashi, T, Yamasaki, M, Miyata, H, Kurokawa, Y, Takiguchi, S, Mori, M & Doki, Y 2013, 'Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach', Esophagus, vol. 10, no. 2, pp. 70-78. https://doi.org/10.1007/s10388-013-0367-7
Hirota M, Nakajima K, Souma Y, Mikata S, Iwase K, Demura K et al. Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach. Esophagus. 2013 Jun 1;10(2):70-78. https://doi.org/10.1007/s10388-013-0367-7
Hirota, Masashi ; Nakajima, Kiyokazu ; Souma, Yoshihito ; Mikata, Syoki ; Iwase, Kazuhiro ; Demura, Koichi ; Takahashi, Tsuyoshi ; Yamasaki, Makoto ; Miyata, Hiroshi ; Kurokawa, Yukinori ; Takiguchi, Shuji ; Mori, Masaki ; Doki, Yuichiro. / Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach. In: Esophagus. 2013 ; Vol. 10, No. 2. pp. 70-78.
@article{222d6136e1c94afa87ae8a91ee6e3e9a,
title = "Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach",
abstract = "Background: Intra-thoracic stomach (ITS) is a rare type of hiatal hernia. Laparoscopic surgery for ITS is technically demanding due to the distorted surgical anatomy. We incorporated assistive esophagoscopy during laparoscopic surgery for ITS. In this study, we assessed the clinical value of esophagoscopy in laparoscopic surgery. Methods: A retrospective data analysis of 11 consecutive patients with ITS was conducted. Laparoscopic surgery was conducted using a standard five-port technique, with the combination of carbon dioxide insufflating flexible esophagoscopy. The main indications for esophagoscopy were, (1) to demonstrate the course of esophagus and stomach during trans-hiatal mediastinal dissection, (2) to identify important anatomic landmarks, e.g., esophago-gastric junction, and (3) to calibrate the esophageal lumen during cruroplasty and/or fundoplication. Data included patient demographics, types of procedures, rate of conversion and/or complications, and surgical outcome. Results: Among 11 patients (9 females, 2 males, median age 75 years), 6 had gastric volvulus. Laparoscopic reduction of ITS with cruroplasty was completed in all cases without intraoperative complications. Six cases required prosthesis. Concomitant procedures were Nissen fundoplication in 9, Collis gastroplasty in 2, and sutured gastropexy in 5 cases. Flexible esophagoscopy enhanced the conduct and completion of these procedures, without any endoscopy-related complications. The median operation time was 247 min, and blood loss was minimal. The postoperative course was uneventful except for transient postoperative dysphagia in 2 cases. No relapse was noted within a median follow-up period of 11 months. Conclusions: Assistive intraoperative esophagoscopy facilitated laparoscopic surgery for ITS, suggesting it could potentially improve the surgical outcome by providing a better view during surgery.",
author = "Masashi Hirota and Kiyokazu Nakajima and Yoshihito Souma and Syoki Mikata and Kazuhiro Iwase and Koichi Demura and Tsuyoshi Takahashi and Makoto Yamasaki and Hiroshi Miyata and Yukinori Kurokawa and Shuji Takiguchi and Masaki Mori and Yuichiro Doki",
year = "2013",
month = "6",
day = "1",
doi = "10.1007/s10388-013-0367-7",
language = "English",
volume = "10",
pages = "70--78",
journal = "Esophagus",
issn = "1612-9059",
publisher = "Springer Japan",
number = "2",

}

TY - JOUR

T1 - Assistive esophagoscopy during laparoscopic surgery for intra-thoracic stomach

AU - Hirota, Masashi

AU - Nakajima, Kiyokazu

AU - Souma, Yoshihito

AU - Mikata, Syoki

AU - Iwase, Kazuhiro

AU - Demura, Koichi

AU - Takahashi, Tsuyoshi

AU - Yamasaki, Makoto

AU - Miyata, Hiroshi

AU - Kurokawa, Yukinori

AU - Takiguchi, Shuji

AU - Mori, Masaki

AU - Doki, Yuichiro

PY - 2013/6/1

Y1 - 2013/6/1

N2 - Background: Intra-thoracic stomach (ITS) is a rare type of hiatal hernia. Laparoscopic surgery for ITS is technically demanding due to the distorted surgical anatomy. We incorporated assistive esophagoscopy during laparoscopic surgery for ITS. In this study, we assessed the clinical value of esophagoscopy in laparoscopic surgery. Methods: A retrospective data analysis of 11 consecutive patients with ITS was conducted. Laparoscopic surgery was conducted using a standard five-port technique, with the combination of carbon dioxide insufflating flexible esophagoscopy. The main indications for esophagoscopy were, (1) to demonstrate the course of esophagus and stomach during trans-hiatal mediastinal dissection, (2) to identify important anatomic landmarks, e.g., esophago-gastric junction, and (3) to calibrate the esophageal lumen during cruroplasty and/or fundoplication. Data included patient demographics, types of procedures, rate of conversion and/or complications, and surgical outcome. Results: Among 11 patients (9 females, 2 males, median age 75 years), 6 had gastric volvulus. Laparoscopic reduction of ITS with cruroplasty was completed in all cases without intraoperative complications. Six cases required prosthesis. Concomitant procedures were Nissen fundoplication in 9, Collis gastroplasty in 2, and sutured gastropexy in 5 cases. Flexible esophagoscopy enhanced the conduct and completion of these procedures, without any endoscopy-related complications. The median operation time was 247 min, and blood loss was minimal. The postoperative course was uneventful except for transient postoperative dysphagia in 2 cases. No relapse was noted within a median follow-up period of 11 months. Conclusions: Assistive intraoperative esophagoscopy facilitated laparoscopic surgery for ITS, suggesting it could potentially improve the surgical outcome by providing a better view during surgery.

AB - Background: Intra-thoracic stomach (ITS) is a rare type of hiatal hernia. Laparoscopic surgery for ITS is technically demanding due to the distorted surgical anatomy. We incorporated assistive esophagoscopy during laparoscopic surgery for ITS. In this study, we assessed the clinical value of esophagoscopy in laparoscopic surgery. Methods: A retrospective data analysis of 11 consecutive patients with ITS was conducted. Laparoscopic surgery was conducted using a standard five-port technique, with the combination of carbon dioxide insufflating flexible esophagoscopy. The main indications for esophagoscopy were, (1) to demonstrate the course of esophagus and stomach during trans-hiatal mediastinal dissection, (2) to identify important anatomic landmarks, e.g., esophago-gastric junction, and (3) to calibrate the esophageal lumen during cruroplasty and/or fundoplication. Data included patient demographics, types of procedures, rate of conversion and/or complications, and surgical outcome. Results: Among 11 patients (9 females, 2 males, median age 75 years), 6 had gastric volvulus. Laparoscopic reduction of ITS with cruroplasty was completed in all cases without intraoperative complications. Six cases required prosthesis. Concomitant procedures were Nissen fundoplication in 9, Collis gastroplasty in 2, and sutured gastropexy in 5 cases. Flexible esophagoscopy enhanced the conduct and completion of these procedures, without any endoscopy-related complications. The median operation time was 247 min, and blood loss was minimal. The postoperative course was uneventful except for transient postoperative dysphagia in 2 cases. No relapse was noted within a median follow-up period of 11 months. Conclusions: Assistive intraoperative esophagoscopy facilitated laparoscopic surgery for ITS, suggesting it could potentially improve the surgical outcome by providing a better view during surgery.

UR - http://www.scopus.com/inward/record.url?scp=84879289011&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84879289011&partnerID=8YFLogxK

U2 - 10.1007/s10388-013-0367-7

DO - 10.1007/s10388-013-0367-7

M3 - Article

AN - SCOPUS:84879289011

VL - 10

SP - 70

EP - 78

JO - Esophagus

JF - Esophagus

SN - 1612-9059

IS - 2

ER -