We found a match
Your institution may have access to this item. Find your institution then sign in to continue.
- Title
A Simple Technique for Jejunojejunal Revision in Laparoscopic Roux-en-Y Gastric Bypass.
- Authors
Spivak, Hadar
- Abstract
Background: The lengths of the bypassed segments in the initial laparoscopic roux-en-Y gastric bypass (LRYGB) are usually a matter of the individual surgeon's routine. The literature is inconclusive about the association between the Roux limbs' length and weight-loss or malabsorption (Stefanidis et al. Obes Surg. 21(1):119-24, ); (Rawlins et al. Surg Obes Relat Dis. 7(1):45-9, ). However, jejunojejunal anastomosis (JJ) 'redo' and Roux limb length revision could be considered for patients with a very short Roux limb and weight loss failure or for short common channel and malabsorption. Complications of JJ may also require revision. Methods: In over 1000 LRYGBs since 2001, eight patients required JJ revision for failure to lose enough weight ( n = 6), malabsorption ( n = 1), and stricture ( n = 1). Instead of completely taking down the JJ, a simple technique was evolved to keep the enteric limb continuity. In a following step, the biliopancreatic limbs have been transected from the JJ and reconnected proximal (for malabsorption) or distal (for weight loss failure). Results: In this video, a step-by-step the laparoscopic technique for JJ revision and relocating the biliopancreatic limb is presented. Procedure takes 40-60 min to perform using four trocars and the hospital stay was 1-2 nights. No complications occurred during the procedures or postoperative period. Conclusions: Laparoscopic revision of JJ is feasible and safe and should be part of surgeons' options on the long-term management of patients post LRYGB.
- Subjects
GASTRIC bypass; REOPERATION; WEIGHT loss
- Publication
Obesity Surgery, 2015, Vol 25, Issue 12, p2461
- ISSN
0960-8923
- Publication type
Article
- DOI
10.1007/s11695-015-1885-2