TY - CHAP M1 - Book, Section TI - Gastrectomy with Roux-en-Y Reconstruction A1 - Hunter, John G. A1 - Spight, Donn H. A1 - Sandone, Corinne A1 - Fairman, Jennifer E. PY - 2018 T2 - Atlas of Minimally Invasive Surgical Operations AB - Gastrectomy is most often performed for gastric cancer or peptic ulcer disease. The complexity of the operation needs to be matched with the expertise of the surgeon. Wedge resection of a small gastric tumor (e.g., leiomyoma) falls on the simpler end of the complexity spectrum and can be performed by most well-trained minimally invasive general surgeons. Total gastrectomy with J-pouch reconstruction and D2 lymph node dissection for proximal gastric cancer falls on the more difficult end of the complexity spectrum and should be performed by experts in minimally invasive surgery for upper GI malignancy. This chapter addresses the more complex procedures, subtotal and total gastrectomy, with extensive (D2) lymph node dissection, the international “standard” for gastric cancer surgery. D2 dissection requires removal of lymph node stations along the celiac trunk, left gastric, splenic, and hepatic arteries. Familiarity with regional lymph node anatomy and the international naming conventions is critical to adequate lymph node harvest and subsequent staging (Figure 1). The final anatomy of the subtotal gastrectomy with Roux en Y gastrojejunostomy is shown (Figure 2). SN - PB - McGraw-Hill Education CY - New York, NY Y2 - 2024/04/19 UR - accesssurgery.mhmedical.com/content.aspx?aid=1162530505 ER -