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Roux-en-O: How It Happens and How to Fix It

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Abstract

The Roux-en-Y gastric bypass surgery improper technique can cause complications such as Roux-en-O, which is caused by an inadvertent anastomosis of the biliopancreatic limb to the gastric pouch, creating an “O” form to the bypass. We present intraoperative images of a mistaken Roux-en-Y's technique that caused the “O” anatomy and its successful reconstruction.

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References

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Authors and Affiliations

  1. Digestive Surgery Department, Hospital Santa Casa de Misericórdia, Porto Alegre, Rio Grande Do Sul, 90035-000, Brazil

    André V. Bigolin, André P. Rodrigues & Juliano N. C. De Lima

  2. Federal University of Health Sciences of Porto Alegre, Porto Alegre, Rio Grande Do Sul, 90050-170, Brazil

    Júlia Iaroseski

Authors
  1. André V. Bigolin
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  2. Júlia Iaroseski
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  3. André P. Rodrigues
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  4. Juliano N. C. De Lima
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Corresponding author

Correspondence to Júlia Iaroseski.

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Human and Animal Rights and Informed Consent

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. For this type of study (retrospective), formal consent is not required.

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The authors declare that they have no conflict of interest.

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Key Points

1. The Roux-en-O can be caused by losing track of the limbs’ origin before the gastroenterostomy.

2. It is important to properly identify the angle of Treitz, the alimentary limb, and the biliopancreatic limb and certify the limbs’ positions before stapling the anastomosis.

3. The reconstruction is made by removing the enteric portion between the gastric pouch and the enteroenterostomy. After this process, the technique can go on as a primary surgery, reestablishing the “Y” form to the gastric bypass.

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Bigolin, A.V., Iaroseski, J., Rodrigues, A.P. et al. Roux-en-O: How It Happens and How to Fix It. OBES SURG 32, 223–224 (2022). https://doi.org/10.1007/s11695-021-05752-9

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  • DOI: https://doi.org/10.1007/s11695-021-05752-9

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