ABSTRACT
Introduction .......................................................................................................................... 112 Laparoscopic Approach to Gastric C ancer .......................................................................112 Laparoscopic Staging o f Gastric C a n cer ........................................................................ 114 Operative Procedure, Preoperative Considerations, Patient E v alu ation .................115 Operative T echnique........................................................................................................... 116 Postoperative C a r e ............................................................................................................... 121 C onclusion ............................................................................................................................. 121
The laparoscopic surgery revolution has resulted from the development o f new techniques and technologies which allow the performance of increasingly com plex procedures. While gastric resection for cancer has not been embraced with such enthusiasm as removal of other abdominal viscera, this may be a reflection o f the relative rarity of this disease in the West. However, a number of groups have undertaken subtotal or total gastrectomy, albeit in small series of patients. Goh et al1 surveyed advanced laparoscopic surgeons and identified a total of 118 laparo scopic gastrectomies performed prior to November 1994. In 46 (38% ) o f these cases, the indication for surgery was gastric cancer. This report included our early cases and established the feasibility o f laparoscopic gastrectomy. This chapter out lines our appraisal of the current role of laparoscopy-both diagnostic and thera peutic-in the management of gastric cancer.
