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 - Jan 1 2001

Keywords

  • Bariatric surgery
  • Gastric bypass
  • Laparoscopy
  • Morbid obesity

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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