ArticleSurgical endoscopy2017
Robotic valvuloplastic esophagogastrostomy using double flap technique following proximal gastrectomy: technical aspects and short-term outcomes.
Article in Surgical endoscopy, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 39 papers, 4 of them syntheses that pooled it.
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Who cites it
39 citing papers in PubMed, 4 syntheses or guidelines pooled it, 55 citations in OpenAlex.
- Pooled it
- Clinical Outcomes According to Surgical Strategies in Proximal Early Gastric Cancer: A Systematic Review and Network Meta-Analysis.Journal of gastric cancer · 2025Pooled it
- Robotic gastrectomy for gastric cancer: systematic review and future directions.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2023Pooled it
- A systematic review of the learning curve in robotic surgery: range and heterogeneity.Surgical endoscopy · 2019Pooled it
- Risk Factors for Anastomotic Stricture and Obstructive Symptoms Following Double-Flap Technique Reconstruction After Proximal Gastrectomy.Annals of gastroenterological surgery · 2026Article
- Applications on proximal gastrectomy with gastroesophageal muscular flap anastomosis in laparoscopic surgery: a narrative review.BMC surgery · 2026Review
- Influence of technical errors on short-term and one-year outcomes after intracorporeal delta-shaped Billroth I anastomosis following minimally invasive distal gastrectomy: a single-center retrospective study.Surgical endoscopy · 2026Article
- Reverse layout of the remnant esophagus and stomach during right transthoracic valvuloplastic esophagogastrostomy in robotic esophagogastric junctional cancer surgery.Gastric cancer : official journal of the International Gastric Cancer Association and the Japanese Gastric Cancer Association · 2026Article
- Laparoscopic proximal gastrectomy with esophagogastrostomy using overlap method combined with gastric remnant "U"-shaped fold: a retrospective cohort study.Frontiers in surgery · 2026Article
- Kamikawa anastomosis in proximal gastrectomy for gastric cancer: A systematic review and meta-analysis.World journal of gastrointestinal surgery · 2025Article
- Article
- Efficacy of robot-assisted double-flap techniques with refinements to minimize anastomosis-related complications after proximal gastrectomy.Surgery today · 2025Article
- The transhiatal tunnel valvuloplasty technique following laparoscopic proximal gastrectomy: the single-center experience in a retrospective cohort.World journal of surgical oncology · 2025Article
- Efficacy of the U-shaped flap technique in preventing reflux after minimally invasive proximal gastrectomy for proximal gastric and esophagogastric junction cancer.Annals of gastroenterological surgery · 2025Article
- Impact of the endoscopic surgical skill qualification system on the oncological safety of laparoscopic gastrectomy for gastric cancer: A single-center retrospective cohort study.Surgical endoscopy · 2024Article
- Safety of robotic double-flap technique following proximal gastrectomy in the introductory phase compared with laparoscopic procedure: a propensity score-matched analysis.Surgical endoscopy · 2024Article
- Standardized procedure for preventing late intestinal complications following minimally invasive total gastrectomy for gastric cancer: a single-center retrospective cohort study.Surgical endoscopy · 2024Article
- A multi-center, prospective, clinical study to evaluate the anti-reflux efficacy of laparoscopic double-flap technique (lD-FLAP Study).Annals of gastroenterological surgery · 2024Article
- Complete laparoscopic and Da Vinci robot esophagogastric anastomosis double muscle flap plasty for radical resection of proximal gastric cancer.Frontiers in oncology · 2024Article
- Robotic esophagectomy with outermost layer-oriented dissection for esophageal cancer: technical aspects and a retrospective review of a single-institution database.Surgical endoscopy · 2023Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundValvuloplastic esophagogastrostomy by double flap technique (VEG-DFT) is a promising procedure to prevent reflux after proximal gastrectomy (PG), and is achieved by the burial of the abdominal esophagus into the gastric submucosa; however, laparoscopic VEG-DFT is technically demanding due to complicated suturing and ligation maneuvers. The present study was designed to determine the feasibility and safety of robotic VEG-DFT.
methodsAfter robotic PG, seromuscular flaps were extracorporeally created at the anterior wall of the remnant stomach through a small umbilical incision. Then, using a robot, the posterior wall of the esophagus was fixed to the cranial end of the mucosal window, and layer-to-layer sutures were placed between the anterior aspects of esophagus and the remnant stomach. Finally, the anastomosis was covered by seromuscular flaps. Short-term outcomes of 12 consecutive patients who underwent VEG-DFT between January 2014 and December 2015 were assessed.
resultsOperations were successfully completed using robotic assistance in all patients. Median operative, surgeon console, and anastomosis times were 406 (324-613 min), 267 (214-483), and 104 (76-186) min, respectively, and median estimated blood loss was 31 (5-130) ml. The first six cases were required to reach a learning plateau. Both mortality and morbidity rates within 30 days after surgery were 0%. Postoperative hospital stay was 10 (9-30) days. No postoperative reflux esophagitis was observed, whereas anastomotic stenosis, which required endoscopic balloon dilation, developed in three patients (25%) in postoperative month 2. There was a significant association between the total number of stitches used for VEG-DFT and anastomotic stenosis (p < 0.001).
conclusionsRobotic assistance may be useful for VEG-DFT with a short learning curve. Attention is required to prevent postoperative anastomotic stenosis possibly caused by an excessive number of stitches for esophagogastrostomy.
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