An Alternative Technique for Creating the Gastrojejunostomy in Laparoscopic Roux-en-Y Gastric Bypass: Experience with 28 consecutive patients

Abstract

LRYGBP was a safe and feasible operation. We believe that our technique is easily reproducible, avoiding the trans-oral route for introducing the anvil. This technique may also decrease operative time and possibly the incidence of wound infections, although we are still in the learning curve and final conclusions cannot be made.

RETRACTED ARTICLE: First Experiences with A Circular Stapled Gastro-Jejunostomy by a New Transorally Introducible Stapler System in Laparoscopic Roux-en-Y Gastric Bypass

“…This technique was later modified by Schauer et al [6] and recently by several other authors [7,8]. The creation of the Roux-en-Y gastrojejunal anastomosis initially required esophagogastroscopic guidance for introduction of the 21-mm circular stapler anvil into the gastric pouch [1,6].…”

Laparoscopic Roux-en-Y gastric bypass

“…LGB that show conversion rates of as high as 23%, major complication rates of as high as 13-20%, leak rates of 2-4%, and average operative times of over 3 h [1,5,9,10,11]. Wittgrove et al report a decrease in their leak rate from 3% to 1% and a decrease in their operative times from 4 h to 90 min with experience [13].…”

“…Our study did not have the power to demonstrate an association between the learning curve and either elevated conversion rates or 2 0 0 Major complications b 10 2 3 Total complications c 24 11 11 OR time (min) d 189 138 125 Conversion a 2 0 1 a p = NS between groups b p = 0.02 between groups A and B, p = 0.65 between groups B and C c p = 0.01 between groups A and B d p < 0.001 between groups A and B, p = 0.02 between groups B and C Teixeira [10] 28 275 min Westling [11] 30 23% 20% Scott [9] 30 0 3% 3% 234 min Matthews [5] 48 0 6% 2% de la Torre [ [2] 400 0 3% 60-90 min Wittgrove [13] Last 200 0 1% 90 min a Author arranged by the number of patients in their series and by their experience…”

“…The learning curve results in elevated complication rates, excessive operative times, and high conversion rates [1,5,9,10,11]. The purpose of this study was to determine the length of the learning curve for a surgeon experienced in advanced laparoscopy.…”

“…Before performing LGB on humans, HJS performed 20 open gastric bypasses, completed a nationally recognized 2-day LGB course, and performed10 LGBs on pigs.Data were collected retrospectively by chart review. Parameters recorded include patient demographic factors, comorbidities, operative times, need for conversion to an open procedure, and perioperative complications.…”