Laparoscopic Billroth II gastrectomy in the canine model.

The feasibility and safety of laparoscopic Billroth II gastrectomy were evaluated in an animate model. After developing the technique in acute animal experiments, laparoscopic antrectomy and Billroth II anastomosis was performed in six mongrel dogs. Video laparoscopic access to the peritoneal cavity was accomplished with six ports (five, 10 mm; one, 12-18 mm). The operations were performed without complication in 150-200 min (mean +/- SEM, 171 +/- 10 min). The animals tolerated solid oral meals on the 2nd or 3rd postoperative day. One dog developed frequent diarrheal stools and lost 3.4 kg prior to sacrifice 18 days postoperatively when a gastroileostomy was discovered. The remaining five animals did well and were sacrificed at 49-77 days postoperatively. Adhesions were minimal and the gastrojejunostomy was widely patent in all animals without evidence of leakage or obstruction. Laparoscopic Billroth II gastrectomy in the canine model is thus feasible and safe. Using laparoscopic guidance, it may be more difficult to identify the ligament of Treitz, which must be assured at the time of operation.