title: Staplerless laparoscopic gastric bypass: a new option in bariatric surgery.
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.
authors: Department of Surgery, Escola Bahiana de Medicina, Av. Princesa Leopoldina 21, Graça, Salvador, Bahia, Brazil. dr.ettinger@gmail.com
authors: João Eduardo Marques Tavares de Menezes
authors: JE
authors: Ettinger
authors: Almino C
authors: AC
authors: Ramos
authors: Euler
authors: E
authors: Azaro
authors: Manoel P
authors: MP
authors: Galvão-Neto
authors: Carlos A B
authors: CA
authors: Mello
authors: Manoela S
authors: MS
authors: Galvão
authors: Paulo C G
authors: PC
authors: Amaral
authors: Andrei
authors: A
authors: Carlo
authors: Edvaldo
authors: E
authors: Fahel