Image Category: Fundamentals: Bariatric Srgy. Patient Select.

Completed Bypass

Completed bypass. The bypass is tested by insufflation of air under saline, or by instillation of methylene blue. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Williams &

The Gastrojejunostomy

The gastrojejunostomy is created by connecting the anvil and shaft of the circular stapler and firing it. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Williams & Wilkins,

Jejunostomy

The jejunostomy is completed by closing the enterotomies (stapled technique, with sewn closure of enterotomies). (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Williams &

The Roux limb is created using a linear stapler

The Roux limb is created using a linear stapler. A hand-sewn technique may also be employed. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Williams & Wilkins, 2005. Used b

Creating Pouch

A. Initial firing of linear stapler to create pouch. B. Completion of pouch. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Williams & Wilkins, 2005. Used by permission.)

Gastric Balloon catheter to facilitate pouch

The stomach is exposed and mobilized. A gastric balloon catheter may be used to define the pouch and facilitate pouch creation. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Willi

Port Placement for Gastric Bypass

Port placement for laparoscopic gastric bypass. Ports B and E should be 12-mm ports. The remaining ports may be 5- or 11-mm ports, depending upon instrumentation; C is the camera port. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and La

Patient position and room setup for gastric bypass

Patient position and room setup for laparoscopic gastric bypass: S, surgeon; A, assistant; CO, camera operator; M, monitor; IT, instrument table. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia

Anvil and gastric wall after transoral delivery

The anvil is pulled through the gastric wall after transoral delivery. (Soper NJ, Swanstrom LL, Eubanks WS, eds. Mastery of Endoscopic and Laparoscopic Surgery. 2d ed. Philadelphia: Lippincott Williams & Wilkins, 2005. Used by permission.)

The pars flaccida technique

The pars flaccida technique. A tunnel is made in the posterior gastric fatty tissue at the level of the gastroesophageal junction and just inferior to the crural confluence. This technique decreases the incidence of posterior gastric herniation.

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