title: The Double Application of the TA-90B Four-row Stapler and Pouch Formation: Eight Rows are Safe and Effective in Roux-en-Y Gastric Bypass.
abstract: Staple-line failure in gastroplasty means eventual weight re-gain in most cases. In gastric bypass this can be disastrous, with a high risk of stomal ulcer formation and reflux esophagitis, as well as weight re-gain. Because of this, total transaction of the two pouches has become more popular, eliminating the staple-line altogether, and thereby preventing any possibility of staple-line failure. However, there is a higher risk of leaks and the two pouches can fistulize into one another, producing the equivalent of a staple-line failure. From July 1987 to August 1991, 350 patients had a Roux-en-Y gastric bypass (RYGBP) with a single application of the TA-90B Autosuturetrade mark instrument, with four known staple-line failures. From August 1991 to May 1993, 210 patients received a double application of the TA-90B four row Autosuturetrade mark stapler. There are no known staple-line failures to date and no leaks, with quite adequate weight loss. This technique has proven safe and effective in the short run.
authors.affiliation: Departments of Surgery, Physicians and Surgeons Hospital and T.E. Schumpert Memorial Medical Center, Shreveport, LA, 71101, USA.
authors.initials: KB
authors.lastname: Jones