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Greater curve approach for laparoscopic gastric bypass: total stapler gastrojejunostomy.
Surg Obes Relat Dis. 2007 Mar-Apr; 3(2):171-5.SO

Abstract

BACKGROUND

Gastric bypass is an established bariatric procedure that has undergone multiple modifications to improve its effectiveness. The side-to-side stapled technique is well recognized, but closure of the gastrotomy/enterotomy by the stapler can potentially narrow the Roux limb. Because of this, many surgeons will hand suture the closure of the gastrotomy/enterotomy. To obviate this difficulty, we inserted the linear stapler from the stomach's greater curvature, using a double-stapled anastomosis that minimized the need for hand suturing.

METHODS

We performed a retrospective analysis of 307 patients undergoing this technique for laparoscopic gastric bypass. The weight loss and 30-day morbidity and mortality were tabulated and compared with those in other published series.

RESULTS

Of the 307 patients, none died postoperatively. The overall 30-day morbidity rate was 15%. Two leaks from the gastrojejunostomy and 2 from the jejunojejunostomy (1.2%) developed. The mean percentage of excess weight loss was 34% at 3 months, 52% at 6 months, 73% at 1 year, 71% at 2 years, and 69% at 3 years.

CONCLUSION

The greater curve approach avoids Roux limb obstruction, minimizes the need for hand suturing, and uses standard trocar incisions. Our short-term follow-up results are similar to those of series of other techniques.

Authors+Show Affiliations

Abilene Diagnostic Surgical Associates, Abilene, Texas, USA.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

17324637

Citation

Frazee, Richard, et al. "Greater Curve Approach for Laparoscopic Gastric Bypass: Total Stapler Gastrojejunostomy." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 3, no. 2, 2007, pp. 171-5.
Frazee R, Einspanier G, Wachtel MS, et al. Greater curve approach for laparoscopic gastric bypass: total stapler gastrojejunostomy. Surg Obes Relat Dis. 2007;3(2):171-5.
Frazee, R., Einspanier, G., Wachtel, M. S., & Frezza, E. E. (2007). Greater curve approach for laparoscopic gastric bypass: total stapler gastrojejunostomy. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 3(2), 171-5.
Frazee R, et al. Greater Curve Approach for Laparoscopic Gastric Bypass: Total Stapler Gastrojejunostomy. Surg Obes Relat Dis. 2007 Mar-Apr;3(2):171-5. PubMed PMID: 17324637.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Greater curve approach for laparoscopic gastric bypass: total stapler gastrojejunostomy. AU - Frazee,Richard, AU - Einspanier,Glennon, AU - Wachtel,Mitchell S, AU - Frezza,Eldo E, Y1 - 2007/02/26/ PY - 2006/06/14/received PY - 2006/11/08/revised PY - 2006/12/18/accepted PY - 2007/2/28/pubmed PY - 2007/6/1/medline PY - 2007/2/28/entrez SP - 171 EP - 5 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 3 IS - 2 N2 - BACKGROUND: Gastric bypass is an established bariatric procedure that has undergone multiple modifications to improve its effectiveness. The side-to-side stapled technique is well recognized, but closure of the gastrotomy/enterotomy by the stapler can potentially narrow the Roux limb. Because of this, many surgeons will hand suture the closure of the gastrotomy/enterotomy. To obviate this difficulty, we inserted the linear stapler from the stomach's greater curvature, using a double-stapled anastomosis that minimized the need for hand suturing. METHODS: We performed a retrospective analysis of 307 patients undergoing this technique for laparoscopic gastric bypass. The weight loss and 30-day morbidity and mortality were tabulated and compared with those in other published series. RESULTS: Of the 307 patients, none died postoperatively. The overall 30-day morbidity rate was 15%. Two leaks from the gastrojejunostomy and 2 from the jejunojejunostomy (1.2%) developed. The mean percentage of excess weight loss was 34% at 3 months, 52% at 6 months, 73% at 1 year, 71% at 2 years, and 69% at 3 years. CONCLUSION: The greater curve approach avoids Roux limb obstruction, minimizes the need for hand suturing, and uses standard trocar incisions. Our short-term follow-up results are similar to those of series of other techniques. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/17324637/Greater_curve_approach_for_laparoscopic_gastric_bypass:_total_stapler_gastrojejunostomy_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(06)01056-2 DB - PRIME DP - Unbound Medicine ER -