| [Purpose]To summarize the experience in applying the linear -manual modified Overlap anastomosis in totally laparoscopic total gastrectomy.[Methods]From January to May 2025, 30 patients with early and advanced gastric cancer were admitted. All of them underwent totally laparoscopic total gastrectomy. The anastomosis method was based on self-pulling and latter transection (SPLT) and was modified with the linear -manual method of Overlap anastomosis.During the self-pulling stage, the esophagus is ligated at the gastroesophageal junction or above, and is then pulled using a ligating suture to separate approximately 6-8 cm of esophageal tissue.Create an entry hole on the right side of the esophagus, insert a linear stapler through this hole, avoid entering the false lumen and achieve side-to-side anastomosis.Subsequently, the esophagus was disconnected using a linear stapler, and the common opening was closed by manual suturing. The total operation time, esophagojejunal anastomosis time, intraoperative blood loss, postoperative complications, postoperative pathology, and prognosis were analyzed.[Results] The average operation time for the 30 patients was 199.8 minutes, with an average time of 14.6 minutes required for esophagojejunostomy. The average intraoperative blood loss was 37.6 mL. None of the 30 patients developed anastomotic leakage or anastomotic stenosis. The modified linear-manual Overlap anastomosis increases the major diameter of the anastomotic stoma, effectively preventing the occurrence of anastomotic-related complications and improving patients' quality of life.[Conclusion] In totally laparoscopic total gastrectomy, the linear -manual modified Overlap anastomosisis a safe and simple surgical method. |
