夏目, 俊之

丸山, 尚嗣

田中, 元

貝沼, 修

松崎, 弘志

宮崎, 彰成

佐藤, やよい

吉岡, 隆文

仙波, 義秀

小林, 拓史

鈴木, 啓介

水内, 喬

玉貫, 圭甲

NATSUME, Toshiyuki

MARUYAMA, Takashi

TANAKA, Hajime

KAINUMA, Osamu

MATSUZAKI, Hiroshi

MIYAZAKI, Akinari

SATO, Yayoi

YOSHIOKA, Takafumi

SENBA, Yoshihide

KOBAYASHI, Hiroshi

SUZUKI, Keisuke

MINOCHI, Takashi

TAMANUKI, Tamaki

[SUMMARY]【Background】How to identify a location of the lesion during totally laparoscopic distal gastrectomy（LDG） is not determined. Intraoperative upper gastrointestinal endoscopy is popular technique,but it is a burden to patients and needs one more endoscopist. Therefore, we detected metallic clip using intraoperative laparoscopic ultrasonography in order to identify lesion and decided to transection line during LDG.【Method】A endoscopic metallic clip（HX-202LR OPLYMPUS） and another endoscopic clip（HX-610-090 OLYMPUS） were applied at 1cm proximal to the lesion prior to LDG. The clips were identified by laparoscopic ultrasonography from the serosal side after the stomach was expanded with water. A lesion and transection line was marked.【Results】16 patients scheduled for LDG were enrolled in this study, in all patient the clips were identified during LDG without complications. The all resection margins were tumor free, with a median proximal margin length of 42.5mm（ range 10-95）.【Conclusions】The detection of metallic clip using intraoperative laparoscopic ultrasonography provided useful and simple to identify lesion during LDG.

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