Laparoscopic gastric surgery. Early experiences.

In the Department of General Surgery the authors performed 12 elective laparoscopic gastric operations for gastric pathologies. The indications for the procedures were recurrent or therapy resistant and complicated peptic ulcer in 9 cases, benign gastric tumors in 2 cases and early gastric cancer in 1 case. Operative procedures were the next: posterior truncal vagotomy with anterior lesser curve seromyotomy (5 patients), total truncal vagotomy with gastrojejunostomy (2 patients), total truncal vagotomy with pyloroplasty (1 patient), total truncal vagotomy with antrectomy and Billroth-II reconstruction (1 patient), resection of benign gastric tumor by the transgastric approach (1 patient), Billroth-II resection for benign gastric tumor (1 patient), wedge resection of gastric wall for early gastric cancer (1 patient). Intraoperative gastroscopy was used for location of the lesion in 4 of 12 cases. Apart from delayed gastric emptying (2 cases), patients recovered without any problem. The mean hospital stay was 5.7 days. Early experiences with laparoscopic gastric surgery has shown that there are certain important advantages to the approaches. They hold the promise of less pain, less immobility, quicker alimentation, shorter hospitalization, less wound and respiratory complications and an earlier return to normal activities.