PMC10320567_01
The steps of laparoscopic surgery for synchronous multiple gastrointestinal cancer. The patient was placed in the lithotomy position. The surgeons' position and the trocar ports were introduced as shown. (a) The positions for distal gastrectomy; (b) the positions for right hemicolectomy; and (c) the positions for anterior resection of rectum. (d) The position of the incision and ports.
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These five ports were used to perform the right-side approach laparoscopic distal gastrectomy with D2 lymphadenectomy (Figure 1a). Ports 1, 3, 4, 5, and 6 were used to perform the separation and dissection of right hemicolectomy with D3 lymphadenectomy (Figure 1b). Thus, Ports 4, 5, 6, 7, and 8 were used to perform the separation and dissection of the anterior resection of rectum (tumor-specific mesorectal excision) (Figure 1c).
The unit for the pneumoperitoneum reestablishing and the laparoscopic camera inserting. The sac wrist of a glove was used to snare the disposable wound retractor. The thumb of the glove was cut off, and a 10 mm port was inserted into the thumb stump. Then, the thumb stump was ligatured by a 1-0 suture.
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The glove's thumb was cut off, and a 10 mm port (Port 7) was inserted into the thumb stump (Figure 2).
Gross specimens and microscopic morphologic pictures of three tumors. (a) distal gastrectomy; (b) right hemicolectomy; and (c) anterior resection of rectum.
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The gross specimens and microscopic morphologic pictures of three tumors are shown in Figure 3.