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RETRACTED ARTICLE: First Experiences with A Circular Stapled Gastro-Jejunostomy by a New Transorally Introducible Stapler System in Laparoscopic Roux-en-Y Gastric Bypass
Authors:Edward Shang  Till Hasenberg  Richard Magdeburg  Michael Keese  Stefan Post  Rudolf Weiner
Institution:(1) Department of Surgery, University Hospital Mannheim, Theodor-Kutzer-Ufer 1-3, 68135 Mannheim, Germany;(2) Department of Surgery, Krankenhaus Sachsenhausen, Frankfurt am Main, Germany
Abstract:

Background

The only effective treatment for patients with morbid obesity is surgery. Laparoscopic bariatric surgery has become quite popular in attempts to decrease the morbidity associated with laparotomy. The aim of this study was to assess the safety and efficiency by using SurgASSIST® for performing the gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass (RYGBP). The variables were compared with the results using the standard laparoscopic circular end-to-end anastomotic stapler (CEEA®).

Methods

After randomization, the gastro-jejuostomy of RYGBP was performed in ten patients by transabdominal introduced circular stapler (group A) and in ten patients by transorally introduced circular stapler (SurgASSIST®; group B) via five-port laparoscopy. A prospective 12-month postoperative follow-up including documentation of minor and major complication as well as weight loss and body composition is done every 8 weeks.

Results

The average body mass index (BMI, 52 kg/m2) and the other baseline characteristics were equally distributed in both groups. There was no difference in reduction of BMI, excess weight loss, and fat mass in both groups. The rate of port site wound infection in group A was significantly higher (p?=?0.03) when compared to group B. There was no anastomotic leak or stricture postoperatively in both groups.

Conclusions

Performing of a gastrojejunostomy in RYGBP by SurgASSIST is a safe and feasible method in comparison to conventional circular stapler systems. The advantage of SurgASSIST is the avoidance to introduce the stapler through the abdominal wall and, by this, a possible port site wound infection. Further prospective studies have to be performed to verify the advantages of the SurgASSIST in comparison to conventional circular stapler systems.
Keywords:Laparoscopy  Roux-en-Y gastric bypass  Bariatric surgery  Gastrointestinal anastomosis  Computerized circular stapling system
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