Laparoscopic distal gastrectomy gastric cancer in a patient with severe kyphosis: A case report and literature review

ABSTRACT: Severe kyphosis poses significant challenges to gastric cancer surgery due to anatomical constraints. This case report details a successful laparoscopic distal gastrectomy in a 71-year-old female with advanced pyloric gastric cancer (cT3N1M0) and severe kyphosis from a prior spinal injury. The patient's spinal deformity, with a 60° Cobb angle, restricted abdominal space, rendering open surgery unfeasible. A laparoscopic approach with modified trocar placement and intraoperative adjustments, including low camera positioning and strategic organ retraction, enabled safe resection and Billroth II anastomosis. The procedure was completed without complications, with oral intake resumed on post-operative day 2 and discharge on day 5. This case demonstrates the feasibility of laparoscopic gastrectomy in patients with complex anatomical variations, highlighting the importance of customised surgical planning to achieve minimally invasive outcomes in challenging scenarios.