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Early Experience with Intraluminal Reinforcement of Stapled Gastrojejunostomy During Laparoscopic Roux-En-Y Gastric Bypass

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Abstract

Background

The use of extraluminal staple-line buttressing material during laparoscopic Roux-en-y gastric bypass has shown the potential to reduce staple-line leak and bleeding. We herein present our early experience with intraluminal reinforcement of linear-cutting stapled gastrojejunal anastomosis with the use of bioabsorbable glycolide copolymer staple-line reinforcement.

Methods

Laparoscopic Roux-en-Y gastric bypass was performed in 80 consecutive non-randomized morbidly obese patients. Gastrojejunal anastomosis was performed using a linear-cutting stapler without staple-line reinforcement in 40 patients (group A), while in the other 40 patients (group B), gastrojejunostomy was performed using a linear cutting stapler with intraluminal reinforcement material (bioabsorbable glycolide copolymer). Demographic data were collected. The rate of gastrojejunal anastomotic leak, bleeding, and stricture was determined.

Results

There was a statistically significant reduction in bleeding complications between the two groups (15% bleeding in group A vs. no bleeding in group B, P value = 0.0255). Stricture rate was higher in-group A (10% group A vs. 2.5% in group B); however, the difference was not statistically significant (P value = 0.2007). None of our patients developed a gastrojejunal leak.

Conclusion

Intraluminal reinforcement of gastrojejunal anastomosis during laparoscopic gastric bypass is safe and feasible. The use of intraluminal bioabsorbable glycolide copolymer staple-line reinforcement significantly reduces the incidence of gastrojejunal bleeding.

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Authors and Affiliations

  1. Minimally Invasive Surgery, Department of Surgery, Michigan State University/Kalamazoo Center for Medical Studies, 1000 Oakland Drive, Kalamazoo, MI, 49008, USA

    Alan A. Saber

  2. General Surgery, Michigan State University/Kalamazoo Center for Medical Studies, 1000 Oakland Drive, Kalamazoo, MI, 49008, USA

    Keith R. Scharf, Ali Z. Turk & Mohamed H. Elgamal

  3. Research Department, Michigan State University/Kalamazoo Center for Medical Studies, Kalamazoo, MI, 49008, USA

    Ruvie L. M. C. Martinez

Authors
  1. Alan A. Saber
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  2. Keith R. Scharf
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  3. Ali Z. Turk
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  4. Mohamed H. Elgamal
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  5. Ruvie L. M. C. Martinez
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Correspondence to Alan A. Saber.

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Saber, A.A., Scharf, K.R., Turk, A.Z. et al. Early Experience with Intraluminal Reinforcement of Stapled Gastrojejunostomy During Laparoscopic Roux-En-Y Gastric Bypass. OBES SURG 18, 525–529 (2008). https://doi.org/10.1007/s11695-008-9465-3

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  • DOI: https://doi.org/10.1007/s11695-008-9465-3

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