Intracorporeal Anastomosis Using a Lapra-Ty Clip in Laparoscopic Distal Gastrectomy: Initial Clinical Experiences

The aim of this study was to assess the efficacy, reliability, and performance of the Lapra-Ty clip (LTc) during intracorporeal Roux-en-Y gastrojejunostomy in a totally laparoscopic distal gastrectomy (TLDG).Between May 2009 and October 2009, we performed TLDG on 25 consecutive early gastric cancer patients. Two-bowel anastomosis was done intracorporeally in the side-to-side fashion using Endo-GIA, and closure of the entry hole was done by LTc with a running suture.There were no postoperative leakages, bleeding, or strictures in the gastrojejunostomies and jejunojejunostomies. We had a single intraoperative complication where the Levin tube was jammed at the gastrojejunostomy site, so a revision was done. Total mean operation time was 254.4 minutes (range, 170-485) and mean anastomosis time was 49 minutes (range, 30-110). Mean hospital stay was 7.9 days (range, 5-17), and mean time to liquid diet was 2.6 days postoperatively (range, 2-5).The usage of LTc is safe and efficient for bowel anastomosis, especially TLDG in humans, and adoption of LTc may help to reduce overall operative times. Perhaps, most importantly, it can cover the disadvantages of TLDG by making TLDG more easily executable in gastric cancer.