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Staplerless Laparoscopic Gastric Bypass: a New Option in Bariatric Surgery |
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| Authors: | João Eduardo Marques Tavares de Menezes Ettinger MD Almino C Ramos MD Euler Ázaro MD PhD Manoel P Galvão-Neto MD Carlos A B Mello MD Manoela S Galvão MD Paulo C G Amaral MD PhD Andrei Carlo MD Edvaldo Fahel MD PhD |
| Affiliation: | 1. Department of Surgery, Escola Bahiana de Medicina, Salvador, Brazil; Bariatric Surgery Division, Hospital S?o Rafael and Hospital Cidade, Salvador, Brazil 2. Gastro Obeso Center, S?o Paulo, Brazil 3. Department of Surgery, Escola Bahiana de Medicina, Salvador, Brazil; Bariatric Surgery Division, Hospital S?o Rafael and Hospital Cidade, Salvador, Brazil 4. Gastro Obeso Center, S?o Paulo, Brazil 5. Bariatric Surgery Division, Hospital S?o Rafael and Hospital Cidade, Salvador, Brazil 6. Gastro Obeso Center, S?o Paulo, Brazil 7. Department of Surgery, Escola Bahiana de Medicina, Salvador, Brazil 8. Gastro Obeso Center, S?o Paulo, Brazil 9. Department of Surgery, Escola Bahiana de Medicina, Salvador, Brazil |
| Abstract: | The staplerless Roux-en-Y gastric bypass (RYGBP) is a new option in bariatric surgery. The first to describe it was Himpens (2004) utilizing the LigaSure Atlas™ (LSA) in a series of 10 patients. The laparoscopic RYGBP is performed utilizing the LSA for the gastric and jejunal partition; after that, an imbricating running suture is performed to ensure stomach and bowel hermetic closure. All anastomoses are hand-sewn. Technical disadvantages are: learning curve; complications related to suture failure; possible thermal/electricity related injuries; longer operating time. Advantages are: stapler-associated bleeding, leaks, staple-line disruption, and fistulas are avoided; cost reduction. The staplerless RYGBP is complex; the surgeon involved requires expertise and ability. This technique will evolve and will be used by more surgeons. It is a new option for the surgeon preoccupied with costs, which is particularly important in developing countries. |
| Keywords: | STAPLERLESS LIGASURE LAPAROSCOPIC GASTRIC BYPASS BARIATRIC SURGERY MORBID OBESITY COST-SAVING |
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