Total gastrectomy and Roux-en-Y reconstruction

Resection of the entire stomach is favored by some surgeons with primary gastric malignancy close to the OG junction. This resection frequently entails regional lymphadenectomy, splenectomy, and distal pancreatectomy. The duodenal stump is oversewn and a Roux-en-Y oesophago jejunostomy is performed. The Roux-en-Y can be Anetecolic (in front ot the transverse colon) or Retrocolic (behind the transverse colon).

This operation is performed via a left thoracoabdominal incision usually centered on the 6th or 7th interspace.

O Oesophagus

D Diaphragm

L Liver

S Spleen

T Tumour

P Pancreas

Pre operative

The resected specimen

When its all put back together