The wonderful use of surgical gloves in total gastrectomy

For laparoscopic total gastrectomy, invasive procedures are a technical challenge and requirement, and successful completion of the surgery requires extremely skilled laparoscopic techniques.

For this surgery, the well-known surgical resection steps are only a part of the procedure. After successful resection, gastrointestinal reconstruction requires the formation of an in vivo esophagojejunal (E-J) anastomosis, which is usually accomplished using the Roux-en-Y jejunal ring.

However, there are many drawbacks in traditional surgical procedures in the past.

Firstly, due to the uncertain induction and maintenance of anesthesia under pneumoperitoneum, and the loose seal around the tubular stapler rod, CO2 is likely to leak from the incision, resulting in loss of surgical field of view or frequent insertion of the tubular stapler outside the jejunal loop (therefore, this surgery should be defined as "endoscopic assisted").

Secondly, in traditional surgical procedures, it is necessary to enlarge the left puncture site for removal, usually to 3-4 cm, and in some cases, the incision needs to be enlarged to 6 cm.

Due to the back and forth movement or rotation of the tubular stapler at the incision site, the enlarged edge of the incision is often torn apart, enlarged, or damaged, leading to potential muscle damage that may increase postoperative pain.