Surgical field—Laparoscopic view- Bowel perforation due to excessive pushing of stapler during laparoscopic gastrojejunostomy anastomosis.
Surgeon using nondominant (left) hand to palpate the head of the stapler/tacking device through the anterior abdominal wall, thus verifying stapler/tacking device position relative to external landmarks and providing counterpressure.
Trocar placement for transabdominal right adrenalectomy. Four 10-mm working trocars are used; if a vascular stapler is needed, one of these can be changed to a 12-mm port.
Placement of trocars in laparoscopic transabdominal left adrenalectomy. Three 10-mm trocars are usually placed initially; if a vascular stapler is needed, the middle trocar can be changed to a 12-mm port.
The stapler has been fired and removed. The staple line has been inspected for hemostasis and is being closed with a simple running suture.