A prospective evaluation of intracorporeal laparoscopic small bowel anastomosis during gastric bypass

Ninh T. Nguyen, Ann M. Neuhaus, Hung S Ho, Levi S. Palmer, Gabriela G. Furdui, Bruce M. Wolfe

Research output: Contribution to journalArticle

25 Scopus citations

Abstract

Background: We evaluated the safety and feasibility of performing a laparoscopic intracorporeal end-to-side small bowel anastomosis using a stapling technique as part of a Roux-en-Y gastric bypass operation (RYGBP). Methods: 80 consecutive patients who underwent RYGBP with laparoscopic jejunojejunostomy were evaluated. Operative time and intraoperative and postoperative complications directly related to the jejunojejunostomy anastomosis were recorded. Results: All 80 laparoscopic jejunojejunostomy procedures were successfully performed without conversion to laparotomy. Mean operative time was longer for the first 40 laparoscopic RYGBP than for the last 40 RYGBP (32±18 min vs 21±14 min, respectively, p<0.05). Intraoperative complications were staple-line bleeding (2 patients) and narrowing of the anastomosis (1 patient). Postoperative complications were four small bowel obstructions: technical narrowing at jejunojejunostomy site (2 patients), angulation of the afferent limb (1 patient), and food impaction at the jejunojejunostomy anastomosis (1 patient). These four patients underwent successful laparoscopic re-exploration and creation of another jejunojejunostomy proximal to the original anastomosis. There were no small bowel anastomotic leaks. The median time to resuming oral diet was 2 days. Conclusions: Laparoscopic jejunojejunostomy as part of the RYGBP operation is a safe and technically feasible procedure. Postoperative small bowel obstruction is a potential complication, which can be prevented by avoiding technical narrowing of the afferent limb.

Original languageEnglish (US)
Pages (from-to)196-199
Number of pages4
JournalObesity Surgery
Volume11
Issue number2
DOIs
StatePublished - 2001

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Keywords

  • Bariatric surgery
  • Gastric bypass
  • Laparoscopy
  • Morbid obesity

ASJC Scopus subject areas

  • Surgery

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