Double-mirror combined with precise “sniping” early gastric cancer

For early gastric cancer, especially early gastric cancer in a special part, because the tumor is located in the inner layer of the gastric wall and has not broken through the gastric wall, it is relatively difficult to locate the outside of the gastric wall in the traditional laparoscopic surgery, and the endoscopic surgery under the gastroscope cannot fully guarantee Radical. In recent years, with the development of laparoscopic and endoscopic technology becoming more and more mature, the combination of two mirrors can easily solve this problem. Double mirror combined surgery can completely remove the tumor in the smallest range, and has the advantages of accurate positioning, less trauma, function preservation, short operation time, and quick recovery.

A few days ago, Mr. Zong visited the 1st Department of Gastrointestinal Surgery of the Second Hospital of the University of China because of early gastric cancer. Gastroscopy results showed early gastric cancer on the posterior wall of the gastric cardia (entrance). Since the tumor site is very special, which surgical method to choose becomes a key consideration. Director Ren Shuangyi of Department 1 of Gastrointestinal Surgery led Deputy Director Zhang Xinsheng and other members of the gastrointestinal tumor team to fully analyze his condition and discuss and study the treatment plan in detail.

The tumor was located on the posterior wall of the gastric cardia, and the tumor could not be seen under simple laparoscopic surgery, and the tumor boundary could not be accurately determined. In the past, laparoscopic total gastrectomy or proximal gastrectomy was usually performed, and it was impossible to preserve more gastric wall tissue on the cardia side. The surgical risk and surgical trauma were relatively large, and cardia stenosis was prone to occur after surgery, and the general structure of the cardia and stomach could not be preserved. . However, it is very difficult to remove the tumor simply by gastroscopic submucosal tumor dissection (ESD), and it is difficult to ensure the integrity and radicalness of the tumor, and it is prone to perforation, which increases the difficulty and time of operation, especially in the cardiac region. Extremely difficult. In the end, the team agreed that gastroscope-assisted laparoscopic double-lens combined (EALT) surgery can skillfully combine the advantages of the two surgical methods while avoiding the disadvantages of a single surgical method, and is more suitable for patients with early gastric cancer like Mr. Zong.

On the day of the operation, Professor Zhang Xinsheng and his team first determined the location and size of the tumor through endoscopy, marked the peripheral resection margin of the tumor with a dye under the gastroscope, and cut the mucosa and submucosa along the edge of the tumor with an electric knife. Then, under the 3D laparoscope, the gastric serosal layer and muscular layer were incised along the dye-marked margin, and the gastroscopic operation “joined forces” to accurately and completely remove the tumor. During the operation, a lymph node tracer was used to dissect the sentinel lymph nodes around the stomach to ensure the radical cure of the tumor.

Professor Zhang Xinsheng and his team performed double-lens combined surgery for the patient

Before the end of the operation, a gastroscopy was performed again to check the surgical wound, check and confirm the integrity and patency of the cardia, and the operation ended smoothly. Six days after the operation, Mr. Zong recovered smoothly and was discharged from the hospital.

Continuous innovation, excellence, and precise treatment are the long-standing pursuits of the Department of Gastrointestinal Surgery. In recent years, under the leadership of Professor Ren Shuangyi, director of gastrointestinal surgery, the department has successfully carried out minimally invasive surgery such as 3D laparoscopic surgery, da Vinci robotic surgery, double mirror combination, NOSES, etc. The team’s diagnosis and treatment level has been praised by many industry experts and patients praise.

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