Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity

Abstract

THE LAPAROSCOPIC Roux-en-Y gastric bypass was first reported by Wittgrove et al¹ in 1994. Although ingenious in the design of their operation, the use and the endoscopic placement of the 21-mm circular stapler (model ECS21 Endopath Stealth Endoscopic/Conventional Circular Stapler; Ethicon Endo-Surgery Inc, Cincinnati, Ohio) was a significant departure from our standard open technique. In addition, anastomotic gastrojejunostomy leak rates of 4% have been reported² and parallel the experiences of Fazio et al³ with colorectal anastomosis using similar stapling devices. We chose to design a surgical procedure that more closely emulates our open procedure both in configuration and formation of the gastric pouch and the gastroenteric anastomosis.