Technical difficulty of laparoscopic radical gastrectomy

The incidence of gastric cancer ranks second among all cancers in my country. With the continuous advancement and development of laparoscopic minimally invasive surgical technology, laparoscopic gastric cancer surgery has become increasingly mature, gradually expanding from the treatment of early gastric cancer to advanced gastric cancer. Because the stomach has rich blood supply, complex anatomical layers, and standardized lymph node dissection is an important factor in improving the prognosis of gastric cancer, the technical requirements for surgeons are higher than those for laparoscopic colorectal cancer. So what are the technical difficulties of laparoscopic radical gastrectomy?

Compared with traditional open surgery, laparoscopic radical gastrectomy can effectively reduce surgery-related trauma and stress response, significantly reduce surgical bleeding, reduce surgical side effects, and promote rapid recovery of patients. According to large-scale long-term case reports at home and abroad, its long-term efficacy is similar to that of traditional open surgery, and there is no significant improvement in postoperative related complications, and the long-term survival rate is similar.
Complications of laparoscopic gastric cancer surgery are mainly divided into three types: (1) complications related to laparoscopic instruments and operations. These include accidental puncture of the pneumoperitoneum needle, "Trocar" damage to abdominal organs, subcutaneous emphysema or hypercapnia, and other common problems faced by all laparoscopic surgeries; (2) systemic complications related to gastric cancer surgery, including lung infection, urinary tract infection, and abnormal liver and kidney function; (3) abdominal complications directly related to gastric cancer surgery. The most common ones are abdominal bleeding, anastomotic leakage or stenosis, pancreatic leakage, small intestinal obstruction, lymphatic leakage, etc.