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Concerning the Letton-Q 'Uncut' Roux Limb-Reply

KEITH A. KELLY, MD; BRENT W. MIEDEMA, MD
Arch Surg. 1992;127(9):1135. doi:10.1001/archsurg.1992.01420090147023.
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In Reply.—We thank Dr Merrill for his cogent comments on our article. We do not claim originality for the uncut Roux operation. In fact, we cite in our article another group that published before us. Others, including Dr Merrill, have also used the operation, and we appreciate his emphasizing this fact in his comments.

Enteric myoneural continuity is necessary to preserve transmission of electrical signals along the small bowel. There is no evidence that the migrating myoelectric complex is harbored in part or in whole in the small-bowel mesentery. In addition, we do not believe that opposition of two cut ends of bowel will allow passive transmission of electrical signals across the cut, as Dr Merrill suggests. Indeed, we recently reported that transection and end-to-end suturing of the jejunum without dividing the mesentery in dogs interrupted propagation of electrical signals across the anastomosis for at least 6 months.1

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