Surgical Endoscopy

, Volume 23, Issue 6, pp 1403–1408 | Cite as

Decreasing anastomotic and staple line leaks after laparoscopic Roux-en-Y gastric bypass

  • Terrence M. FullumEmail author
  • Kanaychukwu J. Aluka
  • Patricia L. Turner



Anastomotic and staple line leaks (ASL) occur after laparoscopic Roux-en-Y gastric bypass (LRYGB) with a reported incidence as high as 6%. Leaks are the second most common cause of post-LRYGB mortality after pulmonary embolism, and can be associated with significant morbidity. Prevention and early detection may limit both morbidity and mortality.


A retrospective analysis of prospectively collected data was performed on all LRYGBs performed in a community hospital by a single surgeon from August 2001 to December 2005. All operations were performed using a linear-stapled anastomosis with buttressing material, handsewn otomy closures, stay sutures, intraoperative leak testing, and fibrin sealant.


760 patients underwent LRYGB during the study period. Eighty-nine percent (n = 674) were female and 11% (n = 86) were male. Mean body mass index (BMI) was 50 kg/m2 (range 36–83 kg/m2). Mean age was 40 years (range 17–72 years). Two patients developed three gastric pouch staple line leaks (0.4%). There were no mortalities.


Operative technique, including appropriate staple sizing, staple line reinforcement, handsewn otomy closures, placement of stay sutures, intraoperative leak testing, and placement of fibrin sealant contributed to a lower than expected incidence of ASL after LRYGB in this series.


Anastomotic and staple line leak (ASL) Gastric bypass 


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Copyright information

© Springer Science+Business Media, LLC 2009

Authors and Affiliations

  • Terrence M. Fullum
    • 1
    Email author
  • Kanaychukwu J. Aluka
    • 1
  • Patricia L. Turner
    • 2
  1. 1.Department of SurgeryHoward University College of MedicineWashingtonUSA
  2. 2.Department of SurgeryUniversity of Maryland Medical CenterBaltimoreUSA

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