Laparoscopic approach to open gastric bypass.
BACKGROUND
Gastric bypass is a successful tool in the treatment of morbid obesity. In recent years, laparoscopic Roux-en-Y gastric bypass has gained popularity. However, open bypass is sometimes more suitable for patients who are "superobese." Laparoscopic instrumentation can be used during an open gastric bypass to facilitate dissection, formation of the gastric pouch, and creation of the gastrojejunostomy.


METHODS
We describe the use of laparoscopic ultrasonic coagulating shears for dissection during open gastric bypass. Additionally, laparoscopic gastrointestinal anastomosis and end-to-end anastomosis staplers are used for creating bowel anastomoses.


CONCLUSIONS
Laparoscopic instrumentation can be useful in the setting of open procedures. Their long handles and jaw design make them ideal for working in the depths of a superobese abdomen.
Department of Surgery MEB 601, Carolinas Medical Center, 1000 Blythe Blvd., Charlotte, NC 28203, USA.
Kristi L
KL
Harold
B Todd
BT
Heniford
Brent D
BD
Matthews
Ronald F
RF
Sing
D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D009767:Obesity, Morbid / Q000150:complications