Roux-en-Y Gastric Bypass with Manual Intracorporeal Anastomoses in 3D Laparoscopy: Operative Technique
Roux-en-Y Gastric Bypass with Manual Intracorporeal Anastomoses in 3D Laparoscopy: Operative Technique
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DOI：
10.1089/lap.2020.0098
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发表时间：
2020-05-14
影响因子：
1.3
通讯作者：
Fournier, Pierre
中科院分区：
文献类型：
--
作者：
Butti, Fabio;Vanoni-Colombo, Alice;Fournier, Pierre
背景资料：减肥手术是唯一被认为是真正有效的治疗严重肥胖的方法，Roux-en-Y胃旁路术是最常见的手术之一。本研究的目的是提出一个三维腹腔镜旁路技术与颅内吻合术，完全由hand.Methods执行：定位后的病人，并创建20 mL的胃袋，胃空肠吻合术进行了两个连续缝合的可吸收的V-锁3.0。采用相同的技术进行侧外侧空肠吻合。所有接受过上述手术的患者都包括在我们的减肥增强术后恢复（ERAS）protocol.Results：旁路ERAS协议和所述技术之间的组合减少了术后疼痛，通常允许患者在48小时内出院。根据我们的经验，使用完全手工缝合吻合的技术与文献中先前描述的技术一样安全，有效，因为使用了胃空肠和空肠空肠吻合的连续缝合而不是吻合器。
Background: Bariatric surgery is the only treatment for severe obesity recognized as truly effective, and Roux-en-Y gastric bypass is one of the most frequent procedures. The aim of this study is to present a 3D laparoscopic bypass technique with intracorporal anastomosis, performed completely by hand.Methods: After positioning the patient and creating the 20 mL gastric pouch, the gastrojejunal anastomosis is performed with two continuous sutures of resorbable V-Lock 3.0. The same technique is used to do the laterolateral jejunojejunal anastomosis. All patients who have undergone the previously described procedure are included in our bariatric enhanced recovery after surgery (ERAS) protocol.Results: The combination between the by-pass ERAS protocol and the described technique reduces postoperative pain, and usually allows discharge of patients within 48 hours.Conclusions: In our experience, the technique using totally handsewn anastomosis is safe as those previously described in the literature and is cost-effective due to the use of continuous suture for the gastrojejunal and the jejunojejunal anastomoses instead of staplers.