Pre-expansion of posterior gastric fascia during laparoscopic radical gastrectomy for gastric cancer prevents injuries to upper short gastric vessels

Splenic injuries during laparoscopic gastrectomy include splenic vascular injury, splenic parenchymal injury and splenic capsule injury. Sometimes, it can lead to lethal hemorrhage. The avoidance of splenic injuries in the laparoscopic radical gastrectomy for gastric cancer is important, especially for the obese patients. Establishing a safe method to avoid splenic injuries in laparoscopic total gastrectomy (LTG) is an urgent issue in the surgical procedure. We developed a novel approach by extended separation of the superficial plane of the posterior gastric fascia to avoid the splenic injury effectively.