title: Reinforced circular stapler in bariatric surgery.
abstract: BACKGROUND
  Roux-en-Y gastric bypass (RYGBP) is the most common procedure for weight loss surgery but has multiple complications. This study evaluates the use of reinforced circular staplers (RCS) and their effects on reducing gastrojejunal anastomotic complications.
  
  
  METHODS
  We conducted a retrospective chart review from January 2007 to November 2008. Laparoscopic RYGBP were performed in 287 patients. A comparison was made of the complications with and without the use of reinforced circular staplers. The comparison was between a nonreinforced circular stapler (NRCS) group comprising 182 patients and an RCS group comprising 105 patients.
  
  
  RESULTS
  Complications at gastrojejunal anastomosis were experienced by 15.3% of the patients; 9.5% were in the RCS group and 18.7% were in the NRCS group (P=0.026). Neither group had anastomotic leaks. Bleeding rate was 4.8% in the RCS group vs. 6.6% in the NRCS group. Ulcers occurred in 2.9% of the RCS group vs. 6.0% of the NRCS group. Stricture rate was 1.9% in the RCS group vs. 6.6% in the NRCS group.
  
  
  CONCLUSIONS
  The application of RCS reduced the incidence of gastrojejunal anastomotic complications. Patients are twice as likely to develop complications when no RCS device is used (95% CI 1.03, 4.623). Therefore, it is beneficial to utilize RCS for the gastrojejunal anastomosis in RYGBP procedures.
authors.affiliation: Department of Surgery, Scott and White Memorial Hospital, The Texas A&M University Health Science Center, 2401 South 31st Street, Temple, Texas 76508, USA. macarago@yahoo.com
authors.forename: Marcela C
authors.initials: MC
authors.lastname: Ramirez
authors.forename: Joaquin
authors.initials: J
authors.lastname: Rodriguez
authors.forename: Flora
authors.initials: F
authors.lastname: Varghese
authors.forename: William H
authors.initials: WH
authors.lastname: Atkinson
authors.forename: Daniel
authors.initials: D
authors.lastname: Rhodes
authors.forename: M Hassan
authors.initials: MH
authors.lastname: Rajab
authors.forename: Richard
authors.initials: R
authors.lastname: Symmonds
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D004867:Equipment Design; D005260:Female; D015390:Gastric Bypass / Q000379:methods*; D006801:Humans; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery*; D012189:Retrospective Studies; D013528:Surgical Staplers; D013536:Suture Techniques / Q000295:instrumentation*; D016896:Treatment Outcome; D055815:Young Adult