title: Stapler division of the omentum and small bowel mesentery in morbidly obese patients undergoing gastric bypass surgery.
abstract: BACKGROUND
  Roux-en-Y gastric bypass (RYGB) procedures can be technically demanding because of anatomical factors including fat distribution, organ fixation, and wound depth. We developed a technique using the Multifire Endo GIA 60 2.5 disposable surgical stapler which allows greater mobilization, less blood loss, and decreased operating time.
  
  
  METHODS
  A disposable stapler designed for laparoscopic surgery was used to transect the gastro-colic omentum and small bowel mesentery in 67 morbidly obese patients undergoing RYGB. Generally, five to six stapler cartridges were needed for the transections.
  
  
  RESULTS
  Stapler division of the gastro-colic omentum and small bowel mesentery decreased operating time by an average of 25 minutes.
  
  
  CONCLUSIONS
  Applying principles of laparoscopic surgery to RYGB resulted in more efficient mobilization of the stomach and the small bowel mesentery, as well as decreased blood loss and operating time.
authors.affiliation: Department of Surgery, Detroit Riverview Hospital, MI, USA.
authors.forename: J A
authors.initials: JA
authors.lastname: Sapala
authors.forename: M H
authors.initials: MH
authors.lastname: Wood
authors.forename: M A
authors.initials: MA
authors.lastname: Sapala
authors.forename: D S
authors.initials: DS
authors.lastname: Mason
mesh_terms: D000713:Anastomosis, Roux-en-Y; D015390:Gastric Bypass / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D008643:Mesentery / Q000601:surgery; D009852:Omentum / Q000601:surgery; D013528:Surgical Staplers; D017792:Surgical Stapling; D013997:Time Factors