Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report

Abstract Background Anastomotic stenosis following esophagojejunostomy reconstruction by the overlap method with absorbable barbed sutures occurs only rarely in patients who have undergone laparoscopic surgery. We report anastomotic stenosis by the overlap method that we attributed to the lack of ta...

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Autores principales:	Daisuke Fujimoto, Keizo Taniguchi, Fumihiko Miura, Hirotoshi Kobayashi
Formato:	article
Lenguaje:	EN
Publicado:	BMC 2021
Materias:	Barbed suture Overlap method Robot-assisted surgery Tactile sensation Surgery RD1-811
Acceso en línea:	https://doaj.org/article/7ebd4ef6a62041dd802b9bd6c034859c
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spelling	oai:doaj.org-article:7ebd4ef6a62041dd802b9bd6c034859c2021-12-05T12:06:26ZAlimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report10.1186/s12893-021-01407-91471-2482https://doaj.org/article/7ebd4ef6a62041dd802b9bd6c034859c2021-11-01T00:00:00Zhttps://doi.org/10.1186/s12893-021-01407-9https://doaj.org/toc/1471-2482Abstract Background Anastomotic stenosis following esophagojejunostomy reconstruction by the overlap method with absorbable barbed sutures occurs only rarely in patients who have undergone laparoscopic surgery. We report anastomotic stenosis by the overlap method that we attributed to the lack of tactile sensation during robot-assisted surgery. Case presentation An 83-year-old man underwent robot-assisted laparoscopic proximal gastrectomy and lymph node dissection at our hospital for treatment of gastric cancer. Double tract reconstruction followed with side-to-side esophagojejunostomy (overlap method) performed with an endoscopic linear stapler. On completion of the anastomosis, the enterotomy was closed under robotic assistance with absorbable barbed suture. Once solid foods were introduced, the patient had difficulty swallowing and felt as though his digestive tract was stopped up. When upper gastrointestinal endoscopy was performed, we found the anastomotic lumen to be coated with food residue. After rinsing off the residue with water, we could see barbed suture protruding into the anastomotic lumen that had become entangled upon itself, which explained how the food residue had accumulated. We cut the entangled suture under endoscopic visualization using a loop cutter. Conclusion This case highlights a stricture caused by insufficiently tensioning barbed suture, which subsequently protruded into the anastomotic lumen and became entangled upon itself. We believe this occurrence was associated with the lack of tactile sensation in robot-assisted surgery.Daisuke FujimotoKeizo TaniguchiFumihiko MiuraHirotoshi KobayashiBMCarticleBarbed sutureOverlap methodRobot-assisted surgeryTactile sensationSurgeryRD1-811ENBMC Surgery, Vol 21, Iss 1, Pp 1-3 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	Barbed suture Overlap method Robot-assisted surgery Tactile sensation Surgery RD1-811
spellingShingle	Barbed suture Overlap method Robot-assisted surgery Tactile sensation Surgery RD1-811 Daisuke Fujimoto Keizo Taniguchi Fumihiko Miura Hirotoshi Kobayashi Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report
description	Abstract Background Anastomotic stenosis following esophagojejunostomy reconstruction by the overlap method with absorbable barbed sutures occurs only rarely in patients who have undergone laparoscopic surgery. We report anastomotic stenosis by the overlap method that we attributed to the lack of tactile sensation during robot-assisted surgery. Case presentation An 83-year-old man underwent robot-assisted laparoscopic proximal gastrectomy and lymph node dissection at our hospital for treatment of gastric cancer. Double tract reconstruction followed with side-to-side esophagojejunostomy (overlap method) performed with an endoscopic linear stapler. On completion of the anastomosis, the enterotomy was closed under robotic assistance with absorbable barbed suture. Once solid foods were introduced, the patient had difficulty swallowing and felt as though his digestive tract was stopped up. When upper gastrointestinal endoscopy was performed, we found the anastomotic lumen to be coated with food residue. After rinsing off the residue with water, we could see barbed suture protruding into the anastomotic lumen that had become entangled upon itself, which explained how the food residue had accumulated. We cut the entangled suture under endoscopic visualization using a loop cutter. Conclusion This case highlights a stricture caused by insufficiently tensioning barbed suture, which subsequently protruded into the anastomotic lumen and became entangled upon itself. We believe this occurrence was associated with the lack of tactile sensation in robot-assisted surgery.
format	article
author	Daisuke Fujimoto Keizo Taniguchi Fumihiko Miura Hirotoshi Kobayashi
author_facet	Daisuke Fujimoto Keizo Taniguchi Fumihiko Miura Hirotoshi Kobayashi
author_sort	Daisuke Fujimoto
title	Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report
title_short	Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report
title_full	Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report
title_fullStr	Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report
title_full_unstemmed	Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report
title_sort	alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report
publisher	BMC
publishDate	2021
url	https://doaj.org/article/7ebd4ef6a62041dd802b9bd6c034859c
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Alimentary tract obstruction attributed to use of barbed suture for double tract reconstruction after robot-assisted proximal gastrectomy: a case report

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