Gao's double-way approach for laparoscopic D2 radical surgery for gastric cancer

摘要

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.