Song B, Wang S, Du QG, Xue F, Mao ZJ, Wu YH. Modified abdominal wall retractor for total laparoscopic esophagojejunostomy in gastric cancer. World J Gastrointest Surg 2026; 18(10): 123136 [DOI: 10.4240/wjgs.123136]
Corresponding Author of This Article
Yun-Hua Wu, The Second Department of General Surgery, Shaanxi Provincial People’s Hospital, No. 256 Friendship West Road, Xi’an 710068, Shaanxi Province, China. wuyunhua199011@163.com
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Surgery
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research-article
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Song B, Wang S, Du QG, Xue F, Mao ZJ, Wu YH. Modified abdominal wall retractor for total laparoscopic esophagojejunostomy in gastric cancer. World J Gastrointest Surg 2026; 18(10): 123136 [DOI: 10.4240/wjgs.123136]
World J Gastrointest Surg. Oct 27, 2026; 18(10): 123136 Published online Oct 27, 2026. doi: 10.4240/wjgs.123136
Modified abdominal wall retractor for total laparoscopic esophagojejunostomy in gastric cancer
Bin Song, Shuai Wang, Qing-Guo Du, Fei Xue, Zhi-Jun Mao, Yun-Hua Wu
Bin Song, Shuai Wang, Qing-Guo Du, Zhi-Jun Mao, Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Shuai Wang, Yan’an Medical College, Yan’an University, Yan’an 716000, Shaanxi Province, China
Fei Xue, Yun-Hua Wu, Second Department of General Surgery, Shaanxi Provincial People’s Hospital, Xi’an 710068, Shaanxi Province, China
Co-first authors: Bin Song and Shuai Wang.
Co-corresponding authors: Zhi-Jun Mao and Yun-Hua Wu.
Author contributions: Song B and Wang S contributed equally to this work, thus qualified as the co-first authors of the paper; Song B, Wang S, Mao ZJ, Wu YH contributed to ceptualization; Song B, Wang S, Du QG contributed to methodology; Fei Xue and Du QG contributed to data curation formal analysis; Du QG and Xue F contributed to writing-original draft; Mao ZJ and Wu YH played important and indispensable roles in the manuscript preparation as the co-corresponding authors; all authors read and approved the final manuscript.
AI contribution statement: No AI tools were used in the preparation of this manuscript.
Supported by Shaanxi Province Key Research and Development Program, No. 2024SF-YBXM-205 and No. 2024SF-YBXM-122.
Institutional review board statement: This retrospective study was approved by the Medical Ethics Committee of Shaanxi Provincial People’s Hospital [approval No. (2024) R164] on July 16, 2024, and conducted in accordance with the Declaration of Helsinki.
Informed consent statement: Written informed consent was obtained from all individual participants included in the study.
Conflict-of-interest statement: The authors declare that they have no competing interests.
Data sharing statement: The datasets used and/or analyzed during the current study are available from the corresponding author on reasonable request.
Corresponding author: Yun-Hua Wu, The Second Department of General Surgery, Shaanxi Provincial People’s Hospital, No. 256 Friendship West Road, Xi’an 710068, Shaanxi Province, China. wuyunhua199011@163.com
Received: May 9, 2026 Revised: June 16, 2026 Accepted: August 31, 2026 Published online: October 27, 2026 Processing time: 156 Days and 4.1 Hours
Abstract
BACKGROUND
Complete intracorporeal esophagojejunostomy remains technically demanding following total gastrectomy. Conventional specialized stapling accessories are not easily available clinically, which hinders wider use of total laparoscopic anastomosis. A modified abdominal retractor was used in our center to simplify relevant surgical steps.
AIM
To compare perioperative results and learning curve between open and modified laparoscopic anastomosis.
METHODS
Eighty-four patients receiving radical total gastrectomy were enrolled retrospectively, consisting of 51 patients treated with traditional open reconstruction and 33 with the modified laparoscopic anastomosis. Baseline features and surgical data were compared, and multivariate regression was used to adjust potential confounding factors. Moving average and cumulative sum methods were utilized to analyze the learning curve of the novel surgical procedure.
RESULTS
Patients receiving laparoscopic surgery had shorter surgical incision, although the overall operation and anastomosis took longer. No significant differences were found in intraoperative bleeding, lymph node retrieval, postoperative rehabilitation indicators or total complication rates. Operating efficiency improved obviously after surgeons finished the initial learning stage of 11 consecutive operations.
CONCLUSION
The modified retractor helps implement safe and feasible total laparoscopic esophagojejunostomy, with a short learning cycle. Further multicenter prospective research is needed to confirm its clinical value.
Core Tip: We designed a customized abdominal wall retractor to facilitate totally intracorporeal esophagojejunostomy after total gastrectomy without costly dedicated stapling accessories. Compared with open anastomosis, this laparoscopic procedure shortens surgical incision while maintaining comparable perioperative safety, and novice surgeons can become proficient with this operative skill after about 11 clinical cases.
