Feasibility of Endo GIA™ Reinforced Reload with Tri-Staple™ Technology for delta-shaped anastomosis

Summary: Background: We report the short-term clinical outcomes of a delta-shaped (DS) anastomosis in laparoscopic distal gastrectomy (LDG), comparing Endo GIA™ Reinforced Reload (Reinforced GIA) with Endo GIA™ (GIA) staplers. Methods: This was a retrospective analysis of 40 patients who underwent totally LDG with DS anastomosis with Reinforced GIA (group A) and 90 patients who underwent the same procedure with GIA (group B) for clinical T1–T3 gastric cancer from May 2013 to December 2016. Operation time, intraoperative blood loss, hospital length of stay, reconstruction time, and complications were compared. Results: No patients required conversion to open surgery, and no patients died. There was no significant difference between the groups regarding patient background, postoperative hospital stay, and operation time. Bleeding from the V-shaped anastomosis was significantly less frequent in group A compared with group B (0% vs 11.2%, p = 0.021). Anastomosis-related complications were less frequent in group A, but there was no statistically significant difference between the groups. The fasting period in group A was significantly shorter than that of group B (2.81 vs 3.39 days, p = 0.034). Conclusion: DS anastomosis using Reinforced GIA can prevent minor postoperative anastomosis leakage. Based on our findings and experience, we recommend DS anastomosis with Reinforced GIA after LDG for gastric cancer as an effective procedure with good short-term outcomes. Keywords: Laparoscopic distal gastrectomy, Reinforced, Delta-shaped anastomosi