Abstract
BACKGROUND: Adequate and stable exposure of the supra-pancreatic region is crucial for improving the quality and outcomes of laparoscopic radical gastrectomy for upper gastric cancer (LRG-UGC). This study aimed to evaluate the application value of stomach hanging maneuver (SHM) in supra-pancreatic lymph node dissection during LRG-UGC. METHODS: A retrospective cohort study was conducted at Zhejiang Cancer Hospital. Clinicopathological data from 80 patients who underwent laparoscopic radical gastrectomy between August 2023 and July 2024 were reviewed. Patients were divided into two groups: conventional exposure (non-suspension group, n = 39) and SHM (SHM group, n = 41). Baseline characteristics and surgical outcomes were compared. Continuous variables with normal distribution were analyzed using the independent-samples t test, non-normally distributed variables with the Mann–Whitney U test, and categorical variables with the chi-square test. RESULTS: Baseline characteristics, including age, sex, BMI, and TNM stage, were comparable between groups (P > 0.05). Compared with the non-suspension group, SHM group had shorter median total operative time (3.31 h), fewer supra-pancreatic grasps (63.00), fewer supra-pancreatic bleeding events (2.00), and fewer total grasps (97.00), with significant differences in these parameters (P < 0.05). CONCLUSION: Compared with the conventional non-suspension approach, SHM appeared to provide better surgical exposure during supra-pancreatic lymph node dissection in LRG-UGC, and was associated with a shorter operative duration and potentially less intraoperative trauma. Taken together, these findings suggest that SHM is a feasible technique, although further validation in larger, well-designed studies is required. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12893-025-03477-5.