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Transumbilical Laparoscopic Roux-en-Y Gastric Bypass with Hand-Sewn Gastrojejunal Anastomosis

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Abstract

Single-port laparoscopic surgery has undergone significant development over the past 5 years. Single port is used in various procedures, including bariatric surgery. The aim of this paper is to describe a surgical technique for gastric bypass with a transumbilical approach (transumbilical gastric bypass—TUGB) with hand-sewn gastrojejunostomy, in selected patients who may be benefited by a better cosmetic result. The procedure begins with a transumbilical vertical incision. We use the GelPOINT single-port device and a 5-mm assistant trocar in the left flank (in the first two cases, a 2-mm subxiphoid liver retractor was used). A gastric pouch is made and calibrated with a 36-Fr bougie. The gastrojejunal anastomosis is performed by hand-sewing in two layers. A Roux-en-Y with a biliary limb of 50 cm and an alimentary limb of 120 cm is performed with a stapler. Three women were subjected to TUGB. The women were aged 28, 31, and 42 years; they had body mass indexes of 40.3, 33, and 38.2; and the operating times were 150, 200, and 150 min, respectively. The first two women underwent a Roux-en-Y gastric bypass (RYGB), and the last woman underwent a RYGB with a resection of the stomach remnant. There were no conversions to open or multitrocar techniques. No complications or deaths occurred. The three patients were satisfied with the cosmetic result. The technique described for TUGB is a feasible procedure for surgeons who have previous experience with the transumbilical approach.

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Acknowledgments

We would like to thank the following individuals for their assistance with the project: Karin Kosiel, Ana María Molina, Andres T. Morales, Alejandra M. Reyes, Claudia C. Basso, Gloria S. Vera, Siomara C. Chahuan, Pía Q. Ulloa, and Eduardo M. Figueroa.

Conflict of Interest

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Authors and Affiliations

  1. Center of Integrated Nutrition and Obesity, Tabancura Clinic [Centro Integral de Nutrición y Obesidad, Clínica Tabancura], Santiago, Chile, 7650018

    José Ignacio Fernández, Cristian Ovalle, Carlos Farias, Jaime de la Maza & Carolina Cabrera

  2. Chile Air Force Clinical Hospital [Hospital Clínico de la Fuerza Aérea de Chile], Santiago, Chile, 7560171

    Cristian Ovalle, Carlos Farias, Jaime de la Maza & Carolina Cabrera

  3. Camino El Radal 17, Condominio Los Portones de Piedra Roja, Chicureo, Colina, Chile, 9361721

    José Ignacio Fernández

  4. Universidad Andres Bello, Santiago, Chile, 8370146

    José Ignacio Fernández

Authors
  1. José Ignacio Fernández
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  2. Cristian Ovalle
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  3. Carlos Farias
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  4. Jaime de la Maza
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  5. Carolina Cabrera
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Corresponding author

Correspondence to José Ignacio Fernández.

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Fernández, J.I., Ovalle, C., Farias, C. et al. Transumbilical Laparoscopic Roux-en-Y Gastric Bypass with Hand-Sewn Gastrojejunal Anastomosis. OBES SURG 23, 140–144 (2013). https://doi.org/10.1007/s11695-012-0804-z

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  • DOI: https://doi.org/10.1007/s11695-012-0804-z

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