Gastric bypass: Transgastric circular stapler technique

Abstract

The circular stapled method of creating the gastrojejunostomy in Roux-en-Y gastric bypass allows for construction of a very small gastric pouch. In addition, it is a safe and relatively simple method of anastomosis. To simplify the technique further, the anvil can be introduced into the gastric pouch through a transabdominal approach instead of the transoral method. This technique reduces the time, cost, and risk that may be associated with intraoperative endoscopy. When the 25-mm anvil is used, the results consistently show a lower stricture rate than with the use of the 21-mm anvil. The role of staple-line reinforcement products with the circular stapled technique is currently under investigation.