Abstract:

Given the close anatomical proximity between the superior spleen and the gastric fundus, the clearance of splenic hilar lymph nodes during total or proximal gastrectomy procedures can lead to bleeding from the superior spleen due to restricted visibility and excessive traction. By accessing the superior spleen through the retrogastric space and creating a peritoneal window on the cranial side of the superior spleen, employing the "gastric short vessel first" strategy for the sequential clearance of splenic hilar lymph nodes from top to bottom can effectively mitigate the challenges associated with this procedure and reduce the risk of intraoperative bleeding incidents.

Key words: Stomach neoplasms, Laparoscopes, Splenic hilus, Lymph node excision