Laparoscopic Devascularization Of The Lower Esophagus And Upper Stomach: Experimental Study In The Pig

Background: Esophagogastric devascularization is an alternative treatment for bleeding gastroe-sophageal varices. The aim of this experimental study was to develop an approach for laparoscopic devascularization of the lower esophagus and upper stomach.Materials and Methods: We used six swine pigs weighing 25 to 25 kg. With the use of five trocars, the steps of the procedure are as follows: (1) dissection of the gastroesophageal junction and mobilization of the esophagus; (2) encircling the abdominal esophagus with umbilical tape; (3) devascularization of the fundus and upper two thirds of the greater curvature of the stomach; and (4) identification and ligation of the left gastric vessels and devascularization of the lesser curvature of the stomach.Results: The mean operative time was 100 minutes (80-120 minutes), and the mean blood loss was 60 mL (40-80 mL). All procedures were completed laparoscopically.Conclusion: Laparoscopic devascularization of the lower esophagus and upper stomach is a technically feasible procedure.