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Laparoscopic Roux-en-Y gastric bypass with linear cutter technique: comparison of four-row versus six-row cartridge in creation of anastomosis.
Surg Obes Relat Dis. 2006 Jul-Aug; 2(4):431-4.SO

Abstract

BACKGROUND

Morbid obesity is refractory to medical treatment. The introduction of laparoscopic linear staplers in the early 1990s contributed to the development of the laparoscopic Roux-en-Y gastric bypass technique. Many series have compared different brands of circular and linear staplers. The purpose of this study was to evaluate the 4-row versus 6-row endoscopic staplers in laparoscopic Roux-en-Y gastric bypass for creation of the anastomosis.

METHODS

Between July 2000 and April 2004, 1240 patients underwent laparoscopic Roux-en-Y gastric bypass. The 4-row linear stapler was used in the first 664 cases (group 1) and the 6-row stapler in the latter 576 patients (group 2) to create the anastomosis. The medical records of those patients who developed leaks, gastrogastric fistulas, strictures, or bleeding were reviewed. Strictures were diagnosed using radiologic or endoscopic techniques.

RESULTS

Leaks were more frequent in group 2 than in group 1 (1.56% versus 1.05%, respectively, P = .46). Documented bleeding occurred in 15 and 13 patients in groups 1 and 2, respectively (2.26% for both). Strictures were diagnosed in 7.68% of patients in group 1 (51 gastrojejunostomy and 4 jejunojejunostomy), and in 4.3% of those in group 2 (25 gastrojejunostomy stenosis, P = .017). Gastrogastric fistulas were found in 5 patients (.75%) in group 1 and 6 (1.04%) in group 2.

CONCLUSION

Using a 6-row instead of a 4-row linear cutter technique to create the anastomosis yielded similar results, but the stricture rate at the gastrojejunal anastomosis was significantly lower with the newer, 6-row staplers.

Authors+Show Affiliations

Bariatric Institute, Cleveland Clinic Florida, Weston, FL 33331, USA. szomsts@ccf.orgNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

16925374

Citation

Szomstein, Samuel, et al. "Laparoscopic Roux-en-Y Gastric Bypass With Linear Cutter Technique: Comparison of Four-row Versus Six-row Cartridge in Creation of Anastomosis." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 2, no. 4, 2006, pp. 431-4.
Szomstein S, Whipple OC, Zundel N, et al. Laparoscopic Roux-en-Y gastric bypass with linear cutter technique: comparison of four-row versus six-row cartridge in creation of anastomosis. Surg Obes Relat Dis. 2006;2(4):431-4.
Szomstein, S., Whipple, O. C., Zundel, N., Cal, P., & Rosenthal, R. (2006). Laparoscopic Roux-en-Y gastric bypass with linear cutter technique: comparison of four-row versus six-row cartridge in creation of anastomosis. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 2(4), 431-4.
Szomstein S, et al. Laparoscopic Roux-en-Y Gastric Bypass With Linear Cutter Technique: Comparison of Four-row Versus Six-row Cartridge in Creation of Anastomosis. Surg Obes Relat Dis. 2006 Jul-Aug;2(4):431-4. PubMed PMID: 16925374.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Laparoscopic Roux-en-Y gastric bypass with linear cutter technique: comparison of four-row versus six-row cartridge in creation of anastomosis. AU - Szomstein,Samuel, AU - Whipple,Oliver C, AU - Zundel,Natan, AU - Cal,Patricio, AU - Rosenthal,Raul, PY - 2005/06/02/received PY - 2006/03/20/revised PY - 2006/03/23/accepted PY - 2006/8/24/pubmed PY - 2006/9/27/medline PY - 2006/8/24/entrez SP - 431 EP - 4 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 2 IS - 4 N2 - BACKGROUND: Morbid obesity is refractory to medical treatment. The introduction of laparoscopic linear staplers in the early 1990s contributed to the development of the laparoscopic Roux-en-Y gastric bypass technique. Many series have compared different brands of circular and linear staplers. The purpose of this study was to evaluate the 4-row versus 6-row endoscopic staplers in laparoscopic Roux-en-Y gastric bypass for creation of the anastomosis. METHODS: Between July 2000 and April 2004, 1240 patients underwent laparoscopic Roux-en-Y gastric bypass. The 4-row linear stapler was used in the first 664 cases (group 1) and the 6-row stapler in the latter 576 patients (group 2) to create the anastomosis. The medical records of those patients who developed leaks, gastrogastric fistulas, strictures, or bleeding were reviewed. Strictures were diagnosed using radiologic or endoscopic techniques. RESULTS: Leaks were more frequent in group 2 than in group 1 (1.56% versus 1.05%, respectively, P = .46). Documented bleeding occurred in 15 and 13 patients in groups 1 and 2, respectively (2.26% for both). Strictures were diagnosed in 7.68% of patients in group 1 (51 gastrojejunostomy and 4 jejunojejunostomy), and in 4.3% of those in group 2 (25 gastrojejunostomy stenosis, P = .017). Gastrogastric fistulas were found in 5 patients (.75%) in group 1 and 6 (1.04%) in group 2. CONCLUSION: Using a 6-row instead of a 4-row linear cutter technique to create the anastomosis yielded similar results, but the stricture rate at the gastrojejunal anastomosis was significantly lower with the newer, 6-row staplers. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/16925374/Laparoscopic_Roux_en_Y_gastric_bypass_with_linear_cutter_technique:_comparison_of_four_row_versus_six_row_cartridge_in_creation_of_anastomosis_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(06)00259-0 DB - PRIME DP - Unbound Medicine ER -