Staplerless laparoscopic gastric bypass: a new option in bariatric surgery

• Published in: Obesity surgery Vol. 16; no. 5; pp. 638 - 645
• Main Authors: Ettinger, João Eduardo Marques Tavares de Menezes, Ramos, Almino C, Azaro, Euler, Galvão-Neto, Manoel P, Mello, Carlos A B, Galvão, Manoela S, Amaral, Paulo C G, Carlo, Andrei, Fahel, Edvaldo
• Format: Journal Article
• Language: English
• Published: United States Springer Nature B.V 01.05.2006
• Subjects: Anastomosis, Roux-en-Y; Brazil; Clinical Competence; Costs and Cost Analysis; Electrocoagulation; Gastric Bypass - economics; Gastric Bypass - methods; Gastrointestinal surgery; Humans; Jejunostomy; Laparoscopy; Methylene Blue; Obesity; Sutures; United States; Weight control; Brazil; United States
• ISSN: 0960-8923; 1708-0428
• DOI: 10.1381/096089206776944896

The staplerless Roux-en-Y gastric bypass (RYGBP) is a new option in bariatric surgery. The first to describe it was Himpens (2004) utilizing the LigaSure Atlas (LSA) in a series of 10 patients. The laparoscopic RYGBP is performed utilizing the LSA for the gastric and jejunal partition; after that, an imbricating running suture is performed to ensure stomach and bowel hermetic closure. All anastomoses are hand-sewn. Technical disadvantages are: learning curve; complications related to suture failure; possible thermal/electricity related injuries; longer operating time. Advantages are: stapler-associated bleeding, leaks, staple-line disruption, and fistulas are avoided; cost reduction. The staplerless RYGBP is complex; the surgeon involved requires expertise and ability. This technique will evolve and will be used by more surgeons. It is a new option for the surgeon preoccupied with costs, which is particularly important in developing countries.