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