Laparoscopic spleen-preserving splenic hilum lymph nodes dissection in total gastrectomy

Complete removal of splenic hilum lymph nodes (LN) while preseraving the spleen and pancreas during laparoscopic total gastrectomy is considered challenging and technical demanding. Based on our accumulated laparoscopic surgical experiences and anatomical understanding of peripancreatic structures, we developed a strategy using retro-pancreatic approach for laparoscopic spleen-preserving splenic hilum LNs dissection for locally advanced proximal gastric cancer.