In 1994, Wittgrove and Clark first described the laparoscopic technique for the Roux-en-Y gastric bypass. Many techniques have been used over the years, mostly based on the use of linear and circular stapling devices for the two anastomoses—the jejeunojejunostomy and the gastrojejunostomy. In 2000, Dr. Kelvin Higa from Fresno described a different technique, with the performance of a hand-sewn gastrojejunostomy. In this article we do review our technique, which is based on Dr. Higa's initial description. The steps of the operation will be illustrated by intraoperative pictures.
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