| 1. Total omentectomy |
|
No injury was made to the any other organ |
| 2. Division of left gastroepiploic artery (it is not necessary to dissect the root of left gastroepiploic artery if the tumor is located in lower third of the stomach) |
4Sb |
The left gastroepiploic artery and left gastroepiploic vein are divided at least below the bifurcation of the first gastric branch |
|
No injury was made to the colon of splenic flexure |
| 4d |
The branch of right gastroepiploic artery and vein are retrieved |
| 3. Appropriate extent of No. 6 lymph node (LN) dissection |
6 |
The right gastroepiploic vein is divided just above the bifurcation of the anterior superior pancreaticoduodenal vein and the right gastroepiploic vein |
|
|
The right gastroepiploic artery is divided just peripheral to the bifurcation of the right gastroepiploic artery and the anterior superior pancreaticoduodenal artery |
|
|
The lowest anterior superior pancreaticoduodenal vein is identified and exposed |
|
|
The prepancreatic soft tissues above the lowest anterior superior pancreaticoduodenal vein are completely removed |
|
|
The prepancreatic soft tissues above the level of the bifurcation of the anterior superior pancreaticoduodenal vein and right gastroepiploic vein are completely removed |
|
|
No injury was made to the pancreatic parenchyma |
| 4. Appropriate extent of No. 5 LN dissection |
5 |
The root of right gastric artery is identified and exposed |
| 5. Appropriate extent of No. 12a LN dissection |
12a |
The lower half of the proper hepatic artery is exposed; at least its anterior and left surfaces |
|
|
The left side of the portal vein is identified and exposed and soft tissues are completely removed |
| 6. Appropriate extent of No. 8a LN dissection |
8a |
The common hepatic artery is exposed; at least its anterior and superior surfaces |
|
|
The soft tissues above the upper edge of the pancreas are completely removed |
| 7. Appropriate extent of No. 9 LN dissection (resection of the celiac plexus is not necessary) |
9 |
The retroperitoneal membrane is divided along the boundary between the right crus and the soft tissues around the celiac trunk to completely dissect No. 9 LNs |
| 8. Appropriate extent of No. 7 LN dissection |
7 |
The root of the left gastric artery is exposed and ligated |
| 9. Appropriate extent of No. 11p LN dissection |
11p |
The proximal half of the splenic artery is exposed, from its root to the site where the meandering splenic artery is in the closest vicinity to the stomach |
|
|
The splenic vein is identified and exposed, or at least the dorsal side of pancreatic parenchyma is exposed |
| 10. Prevention of pancreatic injury during suprapancreatic LN dissection |
|
No pancreatic injury by heat of energy devices and/or assistant’s forceps was caused |
| 11.Appropriate extent of No. 1 and 3 LN dissection |
1, 3 |
The soft tissue attached to the lesser curvature side of gastric wall is completely removed |
|
|
No esophageal and/or gastric injury by heat of energy devices and/or blind manipulation was caused |
