title: Laparoscopic Roux-en-Y Gastric bypass utilizing the triple stapling technique.
abstract: OBJECTIVE
  To evaluate the outcomes of a single surgeon's experience with laparoscopic Roux-en-Y gastric bypass (LRYGB) utilizing the triple stapling technique for creation of the jejunojejunostomy.
  
  
  METHODS
  A retrospective review of patients who underwent LRYGB utilizing the triple stapling technique for creation of the jejunojejunostomy (JJ) between 10/01 and 12/04 was performed.
  
  
  RESULTS
  LRYGB was performed in 435 consecutive patients. The mean age was 41 years (range, 14 to 68), and 82% were female. Mean initial body mass index was 50 (range, 35 to 91). One conversion to open (0.2%) was necessary. Mean operating time was 144+/-26 minutes. Mean length of stay was 2.3+/-1.5 days. There were 3 leaks at the gastrojejunostomy anastomosis (0.7%). No leaks occurred at the JJ anastomosis. One patient underwent revision of the JJ (0.2%) secondary to obstruction of the JJ on upper gastrointestinal study. Intraluminal bleeding occurred in 21 patients (4.8%). Patients required blood transfusion of 2.2+/-1.1 units (range, 0 to 5), but none required surgical or endoscopic intervention. Mortality occurred in 2 patients (0.5%). Mean excess body weight loss was 72% at 1 year.
  
  
  CONCLUSIONS
  Construction of the jejunojejunostomy utilizing the triple stapling technique is expeditious, safe, and associated with minimal complication.
authors.affiliation: Minimally Invasive Surgery Center, Department of Surgery, Evanston Northwestern Healthcare and Northwestern University, Evanston, Ilinois 60201, USA. cfrantzides@enh.org
authors.forename: Constantine T
authors.initials: CT
authors.lastname: Frantzides
authors.forename: Tallal M
authors.initials: TM
authors.lastname: Zeni
authors.forename: Atul K
authors.initials: AK
authors.lastname: Madan
authors.forename: John G
authors.initials: JG
authors.lastname: Zografakis
authors.forename: Ronald E
authors.initials: RE
authors.lastname: Moore
authors.forename: Luis
authors.initials: L
authors.lastname: Laguna
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D010535:Laparoscopy; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000453:epidemiology; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000379:methods*