Abstract
Background Esophagojejunostomy (EJS) in laparoscopic total gastrectomy is a technically challenging and high-risk procedure. Current EJS techniques possess limitations, and an optimal solution remains uncertain. Therefore, we designed and developed a novel laparoscopic titanium purse-string forceps for purse-string suture placement at the distal esophagus. Our study involves laparoscopic total gastrectomy experiments in pigs, comparing EJS outcomes using laparoscopic titanium purse-string forceps with the established OrVil™ technique. Furthermore, we evaluated the feasibility and safety of the laparoscopic titanium purse-string forceps. In total, 20 experimental pigs were randomly assigned to an experimental (n = 10) and a control group (n = 10). The experimental group underwent EJS using the laparoscopic titanium purse-string forceps, whereas the control group underwent EJS using the OrVil™ technique. Preoperative, intraoperative, and postoperative data were collected for subsequent statistical analysis. All 20 pigs underwent the surgical procedure without mortality. Statistically significant differences were observed between the two groups in anvil head placement and fixation time, with the laparoscopic titanium purse-string forceps group exhibiting a shorter duration. Furthermore, the laparoscopic titanium purse-string forceps group demonstrated lower surgical consumable costs compared to the OrVil™ technique group. Conversely, the OrVil™ technique group exhibited an advantage in esophageal rupture repair time. No statistically significant differences were observed between the groups regarding postoperative weight change or other surgery-related data. The laparoscopic titanium purse-string forceps can be used safely and effectively to perform EJS during laparoscopic total gastrectomy. Compared to the OrVil™ technique, these forceps allow for faster and more secure placement and fixation of the anvil head, enhance surgical operability, and offer a more cost-effective alternative.