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World J Gastrointest Surg. Jun 27, 2016; 8(6): 424-426
Published online Jun 27, 2016. doi: 10.4240/wjgs.v8.i6.424
Gao’s double-way approach for laparoscopic D2 radical surgery for gastric cancer
Yong-Shun Gao, Jian-Gang Sun, Jing-Jing Huang, Peng Chen
Yong-Shun Gao, Jing-Jing Huang, Peng Chen, Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Jian-Gang Sun, Neurosurgery, The First Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan Province, China
Author contributions: Gao YS and Sun JG substantial contributions to conception and design of the study, acquisition of data, or analysis and interpretation of data; Sun JG, Huang JJ and Chen P drafting the article or making critical revisions related to important intellectual content of the manuscript; Gao YS final approval of the version of the article to be published.
Conflict-of-interest statement: The authors report no relevant conflicts of interest.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Yong-Shun Gao, Professor, Gastrointestinal Surgery, The First Affiliated Hospital of Zhengzhou University, Erqi area Jianshe East Road No. 1, Zhengzhou 450052, Henan Province, China. 910491705@qq.com
Telephone: +86-371-67967131 Fax: +86-371-64085875
Received: February 25, 2016
Peer-review started: February 26, 2016
First decision: April 6, 2016
Revised: April 13, 2016
Accepted: May 7, 2016
Article in press: May 9, 2016
Published online: June 27, 2016
Abstract

Laparoscopic D2 radical surgery for gastric cancer is minimally invasive but complex. In this path: (1) Repeated operation of lesser curvature side; (2) The gastrohepatic ligament is relatively fixed. Hence, it is not easy to expose the suprapancreatic area; and (3) It is not easy to dissect No. 1, 12 lymph nodes. This area may not be sufficiently cleaned or surrounding vessels may be injured during a resection. So it is critical to choose position fixing, and a clear, fast and convenient operation path. The author, based on his experience, has established a set of procedural steps called “Gao’s double-way”, lesser omentum approach and traditional greater omentum approach, which are described in detail in this article. The path of this first approach is described as a “W” type of dissection. The second way is the traditional greater omentum approach, whose path is described as a “M” type of dissection. This will enable laparoscopic surgeons to select a suitable path. This new approach not only simplifies the surgery but also provides more space for the subsequent operation, thereby making the surgery more simple, safe and easy.

Keywords: Laparoscopic, Gastric cancer, Path, Surgery, Operation

Core tip: This new approach not only simplifies the surgery but also provides more space for the subsequent operation, thereby making the surgery more simple, safe and easy.