Laparoscopic Total Gastrectomy by Alex Nagle, MD

Alex Nagle, MD

This talk appeared at the 2012 SAGES Meeting and was selected via a peer review process


  • Five trochars were used in this procedure. 
  • Operator was located between patient legs and the monitor was located over the patient head. 
  • Lesser sac is entered
  • Dissection is started along greater curvature
  • Short gastric vessels are divided
  • Posterior attachments of stomach are freed
  • Hiatal dissection is performed and attachments of esophagus are dissected 
  • Left gastric pedicle is stapled and transected 
  • Duodenal dissection and transection is performed
  • Esophageal Transection
  • Creation of Roux en Y
  • Jejunojejunostomy
  • Esopheojejunostomy using a circular stapler


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