Laparoscopic Roux-en-Y Gastric Bypass for Morbid Obesity

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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.