Bovine pericardium buttress limits recanalization of the uncut roux-en-Y in a porcine model

Morton, John; Lucktong, Tananchai A; Trasti, Scott L.; Farrell, Timothy M.

doi:10.1016/j.gassur.2003.09.024

Cited by 18 publications

(15 citation statements)

References 11 publications

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“…This appears to take about 2–4 weeks which is similar to previous reports . Although the fate of the staples is unclear, perforation at the stapled blockage has not been observed, in accordance with the reported literature .…”

Section: Discussionsupporting

confidence: 90%

“…Satisfactory recanalization of the stapled ileum occurred in every case and this was verified by subsequent colonoscopy during follow-up. Recanalization of stapled bowel has been reported previously, both in patients [14][15][16] and animal models [17,18], without causing perforation or stricture formation. A proposed explanation for the recanalization of the staple line is the lack of fibrosis between the apposed mucosal surfaces [19,20].…”

Section: O328mentioning

confidence: 97%

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Completely diverted tube ileostomy compared with loop ileostomy for protection of low colorectal anastomosis: a pilot study

et al. 2014

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Section: Discussionsupporting

confidence: 90%

Section: O328mentioning

confidence: 97%

Completely diverted tube ileostomy compared with loop ileostomy for protection of low colorectal anastomosis: a pilot study

et al. 2014

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“…There is one problem with the uncut Roux-en-Y operation: the stapled occlusion of the afferent loop is frequently recanalized, eventually allowing bile access to the gastric remnant [14][15][16]. In this series we did not experience recanalization of the uncut staple line in the afferent loop, and the incidence of Roux stasis syndrome was lower than that in the conventional Rouxen-Y operation.…”

Section: Discussionmentioning

confidence: 89%

Laparoscopy-assisted uncut Roux-en-Y operation after distal gastrectomy for gastric cancer

et al. 2005

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Kelly [8], reported that this method preserved gastric emptying and prevented the Roux stasis syndrome.In Japan, the uncut Roux operation is not yet considered an alternative method. Moreover, the use of the laparoscopic uncut Roux-en-Y gastrojejunostomy after distal gastrectomy has not been reported in the English-language literature. We performed 42 laparoscopic uncut Roux-en-Y gastrojejunostomies for gastric carcinoma. Here we describe the technical details and the initial results of our surgical technique. Method Operating-room setupUnder general anesthesia, each patient was placed in the supine position with the legs apart. A 20° head-up tilt was applied in order to prevent the transverse colon or small intestine from visually compromising the operative field. The surgeon stood on the patient's right, with the first assistant on the patient's left and the camera operator between the patient's legs. Surgical techniqueAfter pneumoperitoneum was established using the open technique, five ports were placed and a flexible electrolaparoscope was introduced through the infraumbilical port.The complete uncut Roux-en-Y gastrojejunostomy is illustrated in the schema in Fig. 1. This method is a modified Billroth II operation, which is accomplished by stapling across the afferent limb of the Billroth II gastrojejunostomy in continuity just proximal to the stomach and performing a side-to-side anastomosis for 40 cm between the afferent limb and the efferent limb, which is designated a "Braun enteroenterostomy".

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“…Based on the findings of that study, we decided to perform isoperistaltic R-Y reconstruction after TLDG. Uyama et al intracorporeally performed 42 laparoscopically assisted uncut R-Y gastrojejunostomy procedures [28][29][30][31] in order to prevent development of R-Y stasis [32,33]; they reported only one problem with this uncut R-Y operation, which involved the frequent recanalization of the stapled occlusion of the afferent loop [34][35][36]. In the present study, we did not observe the development of postoperative R-Y stasis in any of the 105 patients.…”

Section: Discussionmentioning

confidence: 99%

β-Shaped intracorporeal Roux-en-Y reconstruction after totally laparoscopic distal gastrectomy

et al. 2013

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Background The use of laparoscopic gastrectomy for the treatment of gastric cancer has been increasing. Roux-en-Y (R-Y) reconstruction after laparoscopy-assisted distal gastrectomy is now widely used to decrease leakage and prevent reflux. Owing to the need for a less invasive technique, we have developed a new technique for intracorporeal R-Y reconstruction (b reconstruction) after totally laparoscopic distal gastrectomy (TLDG). Methods In this report, we describe the b reconstruction technique and short-term outcomes of the initial 105 patients who underwent b reconstruction from December 2008 to March 2012. Results The operative and b reconstruction times were 330 ± 61.3 and 29 ± 5.6 min (mean ± SD), respectively. Anastomotic leakage after gastrojejunostomy occurred in one patient (0.9 %), requiring reoperation. Four cases (3.8 %) of anastomotic stenosis required endoscopic balloon dilation. However, R-Y stasis was not noted. ConclusionsWe have indicated a technical description as well as the usefulness of b-shaped intracorporeal R-Y reconstruction after TLDG.

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Bovine pericardium buttress limits recanalization of the uncut roux-en-Y in a porcine model

Cited by 18 publications

References 11 publications

Completely diverted tube ileostomy compared with loop ileostomy for protection of low colorectal anastomosis: a pilot study

Completely diverted tube ileostomy compared with loop ileostomy for protection of low colorectal anastomosis: a pilot study

Laparoscopy-assisted uncut Roux-en-Y operation after distal gastrectomy for gastric cancer

β-Shaped intracorporeal Roux-en-Y reconstruction after totally laparoscopic distal gastrectomy

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