scholarly journals Stricture Rate after Laparoscopic Roux-en-Y Gastric Bypass with a 21-mm Circular Stapler versus a 25-mm Linear Stapler

2015 ◽  
Vol 10 (1) ◽  
pp. 33-37 ◽  
Author(s):  
Leopoldo M. Baccaro ◽  
Kalyan Vunnamadala ◽  
Aniket Sakharpe ◽  
B. Jakub Wilhelm ◽  
Artun Aksade
Keyword(s):  
Gastric Bypass ◽  
Circular Stapler ◽  
Linear Stapler ◽  
Stricture Rate

scholarly journals Feasibility and Short-Term Outcomes of Three-Dimensional Hand-Sewn Esophago-Jejunal Anastomosis in Completely Laparoscopic Total Gastrectomy for Cancer

Cancers ◽  
2021 ◽  
Vol 13 (18) ◽  
pp. 4709
Author(s):  
Alexandros Charalabopoulos ◽  
Spyridon Davakis ◽  
Panorea Paraskeva ◽  
Nikolaos Machairas ◽  
Αlkistis Kapelouzou ◽  
...  
Keyword(s):  
Anastomotic Leak ◽  
Total Gastrectomy ◽  
Operating Time ◽  
Three Dimensional ◽  
Circular Stapler ◽  
Laparoscopic Total Gastrectomy ◽  
Linear Stapler ◽  
Limited Data ◽  
Stricture Rate ◽  
Siewert Type Iii

Laparoscopic total gastrectomy is on the rise. One of the most technically demanding steps of the approach is the construction of esophago-jejunal anastomosis. Several laparoscopic anastomotic techniques have been described, like linear stapler side-to-side or circular stapler end-to-side anastomosis; limited data exist regarding hand-sewn esophago-jejunal anastomosis. The study took place between January 2018 and June 2021. Patients enrolled in this study were adults with proximal gastric or esophago-gastric junction Siewert type III tumors that underwent 3D-assisted laparoscopic total gastrectomy. A hand-sewn esophago-jejunal anastomosis was performed in all cases laparoscopically. Forty consecutive cases were performed during the study period. Median anastomotic suturing time was 55 min, with intra-operative methylene blue leak test being negative in all cases. Median operating time was 240 min, and there were no conversions to open. The anastomotic leak rate and postoperative stricture rate were zero. The 30- and 90-day mortality rates were zero. Laparoscopic manual esophago-jejunal anastomosis utilizing a 3D platform in total gastrectomy for cancer can be performed with excellent outcomes regarding anastomotic leak and stricture rate. This anastomotic approach, although technically challenging, is safe and reproducible, with prominent results that can be disseminated in the surgical community.

scholarly journals Linear versus Circular Stapler for Gastrojejunal Anastomosis in Laparoscopic Roux-En-Y Gastric Bypass: An Analysis of 211 Cases

2020 ◽  
Vol 2020 ◽  
pp. 1-6
Author(s):  
Laurin Burla ◽  
Pascal Weibel ◽  
Cornelia Baum ◽  
Markus Huber ◽  
Thomas Gürtler ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Circular Stapler ◽  
Linear Stapler ◽  
Gastrojejunal Anastomosis ◽  
Average Weight ◽  
Wound Infections ◽  
Significant Difference ◽  
Stapler Technique ◽  
One Year

Purpose. Although laparoscopic Roux-en-Y gastric bypass (LRYGB) is a frequently performed bariatric procedure, there is still no consensus on its technical implementation. Methods. 211 patients treated with LRYGB in a single institution between March 2011 and October 2016 were analyzed retrospectively. A subgroup analysis for the linear (LSA) versus circular stapler technique (CSA) for gastrojejunal anastomosis (GJA) was performed to evaluate complications and outcomes. Results. 128 (60.6%) patients received GJA with CSA and 83 (39.4%) with LSA. Average weight loss one year after surgery, respectively, BMI after one year of follow-up (kg/m2), showed no significant difference. Median surgery time was significantly shorter in the LSA group. If the procedure was performed with CSA, significantly more wound infections occurred. Conclusions. Both the circular and the linear stapler techniques for gastrojejunal anastomosis in laparoscopic Roux-en-Y gastric bypass are safe methods with comparable outcomes. A disadvantage of CSA is the significantly higher rate of wound infections, a circumstance which requires increased attention.

Vertical Banded Gastroplasty

2018 ◽  
Author(s):  
Maria R. Ver ◽  
Tammy S. Fouse
Keyword(s):  
Gastric Bypass ◽  
Vertical Banded Gastroplasty ◽  
Revisional Surgery ◽  
Circular Stapler ◽  
Adjustable Gastric Band ◽  
Late Complications ◽  
Linear Stapler ◽  
Mesh Migration ◽  
Gastric Distention ◽  
Banded Gastroplasty

Vertical banded gastroplasty (VBG) is the construction of a small vertical pouch using a linear stapler, with addition of a Marlex band placed through a window formed by a circular stapler. Compared to gastric bypass, VBG maintains a more normal anatomy of the upper gastrointestinal tract. However, due to poor long-term outcomes and a high percentage of patients requiring revisional surgery, most bariatric surgeons have abandoned VBG as a primary bariatric procedure. Early complications include acute gastric distention and gastric leaks. Late complications include mesh migration or erosion, stomal stenosis, staple-line disruption, and gastrogastric fistulas. The most common revision is to Roux-en-Y gastric bypass (RYGB). There are reports of other revisions, such as the vertical banded gastroplasty−gastric bypass (VBG-GB), re-VBG, RYGB-on-VBG, VBG to duodenal switch, VBG to biliopancreatic diversion, VBG to sleeve gastrectomy, VBG to adjustable gastric band, and VBG reversal, as well as endoscopic alternatives.

scholarly journals New Device for the Introduction of a Circular Stapler in Laparoscopic Gastric Bypass Surgery

2006 ◽  
Vol 16 (12) ◽  
pp. 1559-1562 ◽  
Author(s):  
Markus Müller ◽  
Stefan Wildi ◽  
Pierre-Alain Clavien ◽  
Markus Weber
Keyword(s):  
Gastric Bypass ◽  
Laparoscopic Gastric Bypass ◽  
Bypass Surgery ◽  
Gastric Bypass Surgery ◽  
Circular Stapler ◽  
New Device

scholarly journals Step-by-step esophagojejunal anastomosis after intra-corporeal total gastrectomy for laparoscopic gastric cancer treatment: technique of "reverse anvil"

2014 ◽  
Vol 27 (1) ◽  
pp. 71-76 ◽  
Author(s):  
Croider Franco LACERDA ◽  
Paulo Anderson BERTULUCCI ◽  
Antônio Talvane Torres de OLIVEIRA
Keyword(s):  
Total Gastrectomy ◽  
Circular Stapler ◽  
Jejunal Loop ◽  
Linear Stapler ◽  
Treatment Technique ◽  
Esophagojejunal Anastomosis ◽  
Technical Details ◽  
Gastric Cancer Treatment ◽  
Gastric Tubes ◽  
The Moment

Background: The laparoscopic gastrectomy is a relatively new procedure due mainly to the difficulties related to lymphadenectomy and reconstruction. Until the moment, technique or device to perform the esophagojejunal anastomosis by laparoscopy is still a challenge. So, a safe, cheap and quickly performing technique is desirable to be developed. Aim : To present technique proposed by the authors with its technical details on reconstruction with "reverse anvil". Method: After total gastrectomy completed intra-corporeally, the reconstruction starts with the preparation of the intra-abdominal esophagus cross-section next to the esophagogastric transition of 50%. A graduated device is prepared using Levine gastric tubes (nº. 14 and 10), 3 cm length, connected to the anvil of the circular stapler (nº. 25) with a wire thread (2-0 or 3-0) of 10 cm, which is connected to end of this device. The whole device is introduced in reverse esophagus. The esophagus is amputated and the wire is pulled after previous transfixation in the distal esophagus and the anvil positioned. The jejunal loop is sectioned 20-30 cm from duodenojejunal angle, and the anvil put in the jejunal loop and connect previously in the esophagus. Linear stapler (blue 60 mm) is used to close the opening of the jejunal loop. Conclusion: The "reverse anvil" technique used by the authors facilitated the transit reestablishment after total gastrectomy, contributing to obviate reconstruction problems after total gastrectomy.

A553 Alexis wound retractor in roux-en-Y gastric bypass: reducing surgical site infection associated with circular stapler use

2019 ◽  
Vol 15 (10) ◽  
pp. S229
Author(s):  
David Pechman ◽  
Fernando Munoz Flores ◽  
Victoria Needham ◽  
Ruben Salas Parra ◽  
Giulianna Cupello ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Surgical Site Infection ◽  
Circular Stapler ◽  
Site Infection ◽  
Wound Retractor

Dual Ring Wound Protector Reduces Circular Stapler Related Surgical Site Infections in Patients Undergoing Laparoscopic Roux-En-Y Gastric Bypass

2018 ◽  
Vol 28 (10) ◽  
pp. 3352-3359 ◽  
Author(s):  
Jennwood Chen ◽  
Margaux Miller ◽  
Anna Ibele ◽  
Ellen Morrow ◽  
Robert Glasgow ◽  
...  
Keyword(s):  
Gastric Bypass ◽  
Circular Stapler ◽  
Surgical Site Infections ◽  
Wound Protector ◽  
Dual Ring
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