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.
A. Division of the appendiceal base using pretied sutures. B. Division of the base using the endoscopic stapling device.
Passing the Silastic feeding jejunostomy tube into the lumen of the jejunum and tying the sutures.
The anchoring sutures are being placed. The suture is passed through the abdominal wall, a seromuscular bite of intestine is taken, and the suture is then passed out of the abdomen. Four sutures are placed in a diamondshaped configuration, providing both
The small bowel segment chosen for resection has been suspended by traction sutures passed through the anterior abdominal wall. This facilitates subsequent dissection of mesenteric vessels and provides retraction without additional graspers or trocars.