Many techniques for creating the gastrojejunal anastomosis while performing laparoscopic gastric bypass in obese patients have been described. The stapled anastomoses comprise the circular stapler technique, using either a 21 or a 25-mm anvil, and the linear stapler technique. The handsewn anastomosis, which seems to offer some advantages over the mechanical technique, is being performed with increased frequency. The three techniques are described here and discussed in the light of our own experience.
2. Angrisani L , Favretti F , Furbetta F , et al for the Italian Group for Lap-Band System: Results of multicenter study on patients with BMI < or = 35kg/M2 . Obes Surg14(3): 415-418 , 2004.
3.
3. Wittgrove AC , Clark GW , Schubert KR : Laparoscopic gastric nypass, Roux-en-Y: Technique and results in 75 patients with 3-30 months follow up . Obes Surg6(6): 500-504 , 1996.
4.
4. Weiner R , Blanco-Engert R , Weiner S , et al: Outcome after laparoscopic adjustable gastric binding-8 years experience . Obes Surg13(3): 427-434 , 2003.
5.
5. O'Brien P , Brown W , Dixon J : Revisional surgery for morbid obesity-conversion to the Lap-Band system . Obes Surg10(6): 557-563 , 2000.
6.
6. Higa KD , Ho T , Boone KB : Laparoscopic Roux-en-Y gastric bypass: Technique and 3-years follow-up, LaparoendoscAdv Surg Tech A11(6): 377-382 , 2001.
7.
7. Champion JK , Williams M . Small bowel obstruction and internal hernias after laparoscopic Roux-en-Y gastric bypass . Obes Surg. 2003 Aug; 13(4): 596-600 .
8.
8. Schauer PR , Ikramuddin S , Gourash W , et al: Outcomes after laparoscopic Roux-en-Y gastric bypass for morbid obesity . Ann Surg232(4): 515-529 , 2000.
9.
9. Higa KD , Boone KB , Ho T , Davies OG : Laparoscopic Rouxen-Y gastric bypass for morbid obesity: technique and preliminary results of our first 400 patients . Arch Surg135(9): 1029-1033 , 2000.
10.
10. Fobi M , Lee H , Igwe D , et al: Band erosion: Incidence, etiology, management and outcome after banded vertical gastric bypass . Obes Surg11(6): 699-707 , 2001.
11.
11. Fobi MA , Surgical treatment of obesity: A review . J Natl Med Assoc96(1): 61-75 , 2004.
12.
12. Huscher CG , Anastasi A , Crafa F , et al: Laparoscopic gastric resections . Semin Laparosc Surg7(1): 26-54 , 2000.
13.
13. Jordan DR , Klapper SR , Gilberg SM : The use of Vicryl mesh in 200 porous orbital implants: A technique with few exposures . Ophthal Plast Reconstr Surg19(1): 53-61 , 2003.
14.
14. Jacob BP , Gagner M , Hung TI , et al: Dual endoscopic-assisted endoluminal colostomy reversal: A feasibility study . Surg Endosc18(3): 433-439, 2004.
15.
15. Wittgrove AC , Clark GW : Combined laproscopic/endoscopic anvil placement for the performance of the gastroenterostomy . Obes Surg11(5): 565-569 , 2001.
16.
16. Nguyen NT , Stevens CM , Wolfe BM : Incidence and outcome of anastomotic stricture after laparoscopic gastric bypass , J Gastrointest Surg7(8): 997-1003 , 2003.
17.
17. Stahl RD : Comparison of 21 vs. 25 mm gastrojejunostomy in the gastric bypass procedure-early results . Obes Surg10(6): 540-542 , 2000.
18.
18. Nguyen NT , Wolfe BM : Hypopharyngeal perforation during laparoscopic Roux-en-Y gastric bypass . Obes Surg10(1): 64-67 , 2000.
19.
19. Potvin M , Gagner M , Pomp A : Laparoscopic Roux-en-Y gastric bypass for morbid obesity: A feasibility study in pigs . Surg Laparosc Endosc7(4): 294-297 , 1997.
20.
20. Kirkpatrick AW , Baxter KA , Simons RK , et al: Intra-abdominal complications after surgical repair of small bowel injuries: An international review , J Trauma55(3): 399-406 , 2003.
21.
21. Murr MM , Gallagher SF : Technical considerations for transabdominal loading of the circular stapler in laparoscopic Rouxen-Y gastric bypass . Am J Surg185(6): 585-588 , 2003.
22.
22. Cadiere GB , Himpens J , Vleugels T : How to perform laparoscopic gastric bypass [French] . Journ de Coelio Chir36: 25-31 , 2003.
23.
23. Shope TR , Cooney RN , Mc Leod J , et al: Early results after laparoscopic gastric bypass: EEA vs GIA stapled gastrojejunal anastomosis , Obes Surg13(3): 355-359 , 2003.
24.
24. Lonroth H , Dalenback J , Haglind E , Lundell L : Laparoscopic gastric bypass. Another option in bariatric surgery . Laparosc Surg Endosc10(6): 636-638 , 1996.
25.
25. Champion JK , Hunt T , DeLisle N : Role of routine intraoperative endoscopy in laparoscopic bariatric surgery . Surg Endosc16(12): 1663-1665 , 2002.
26.
26. Champion JK , Williams M : Prospective randomized comparison of linear staplers during laparoscopic Roux-en-Y gastric bypass . Obes Surg13(6): 855-859 , 2003.
27.
27. Catena F , La Donna M , Gagliardi S , et al: Stapled versus hand-sewn anastomoses in emergency intestinal surgery: Results of a prospective randomized study . Surg Today34(2): 123-126 , 2004.
28.
28. Gonzales R , Lin E , Venkatesh KR , et al: Gastrojejunostomy during laparoscopic gastric bypass: Analysis of 3 techniques . Arch Surg138(2): 181-184 , 2003.
29.
29. Mouiel J : Morbid obesity, public health problem: Laparoscopic surgical treatment . Bull Acad Natl Med185(8): 1475-1490 , 2001.
30.
30. Rutledge R : Similarity of Magenstrasse-and-Mill and Mini-Gastric bypass . Obes Surg13(2): 318-318 , 2003.
31.
31. Basso N , Rosato P , De Leo A , et al: Laparoscopic treatment of gastric stromal tumors . Surg Endosc14(6): 524-526 , 2000.
32.
32. McDonald CC , Baird RL : Intestinal anastomosis with one-layer absorbable suture . Am Surg47(10): 439-440 , 1981.
33.
33. Baltasar A , Bou R , Miro J , et al: Laparoscopic biliopancreatic diversion with duodenal switch: Technique and initial experience . Obes Surg12(2): 245-248 , 2002.
34.
34. Himpens JM , Debilde D , Leman GM , Cadiere GB : Band gastroplasty compared to sleeve gastrectomy in the treatment of obesity for non-sweet eaters . Journ de Coelio Chir50: 20-26 , 2004.
