Selecting and Affixing loop of jejunum
A loop of jejunum has been selected and affixed to the greater curvature of the stomach, above the gastroepiploic vessels, with two stay sutures. Two enterotomies have been made and the stapling device inserted.
Inspecting the staple line for hemostasis
After the staple line has been inspected for hemostasis, the enterotomies are closed with a running suture. (Reprinted with permission from Bogen GL, Mancino AT, Scott-Conner CE. Laparoscopy for staging and palliation of gastrointestinal malignancy. Surg
Enterotomies
Stay sutures have been placed and tied. Two enterotomies have been made and the stapler is inserted into the two enterotomies. The bowel and gallbladder must be carefully positioned to fully utilize the entire length of the stapling device (by pulling the
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 &