0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Operative Technique |

Triple-Stapling Technique for Jejunojejunostomy in Laparoscopic Gastric Bypass

Atul K. Madan, MD; Constantine T. Frantzides, MD,PhD
Arch Surg. 2003;138(9):1029-1032. doi:10.1001/archsurg.138.9.1029.
Text Size: A A A
Published online

Extract

Since its introduction in 1994,1 laparoscopic gastric bypass has become an increasingly popular procedure for the surgical treatment of morbid obesity. In fact, it has been stated that the most prevalent laparoscopic bariatric procedure in the United States is the gastric bypass.2 Multiple studies have demonstrated the safety and efficacy of this procedure.35 One well-designed prospective randomized study by Nguyen et al6 comparing the laparoscopic approach with the open approach showed a shorter convalescence, a shorter hospital stay, and less blood loss with the laparoscopic gastric bypass. In addition, the patients who underwent this procedure had more rapid improvement in their quality of life and an amount of weight loss comparable with that of the patients in the open group.

Figures in this Article

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

First Page Preview

View Large
First page PDF preview

First Page Preview

View Large
First page PDF preview

Figures

Place holder to copy figure label and caption
Figure 1.

Diagram demonstrates the stenosis that can occur when using the double-stapling technique.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 2.

Two enterotomies are placed in each limb of the bowel. The enterotomy in the limb from the duodenum is placed 5 cm from the transected end.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 3.

A laparoscopic linear cutter (from the umbilical port) is placed into the antimesenteric side of the 2 limbs.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 4.

To position the bowel, it is rotated 90° and cephalad.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 5.

A laparoscopic linear cutter (from the left lateral port) is placed into the antimesenteric side of the 2 limbs. This firing is 180° from the firing position of the original staper.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 6.

Another laparoscopic linear cutter (from the umbilical port) is used to close the common enterotomy.

Graphic Jump Location
Place holder to copy figure label and caption
Figure 7.

Anastomosis is demonstrated with no evidence of stenosis.

Graphic Jump Location

Tables

References

Correspondence

CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.
Submit a Comment

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Web of Science® Times Cited: 35

Sign in

Create a free personal account to sign up for alerts, share articles, and more.

Purchase Options

• Buy this article
• Subscribe to the journal

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles
Jobs
brightcove.createExperiences();