Pull Technique for Introducing the Anvil During Gastric Pouch-jejunal Limb Anastomosis in Lrygb

Amarit Tansawet, MD, Suphakarn Techapongsatorn, MD, Sopon Lerdsirisopon, MD, Wisit Kasetsermwiriya, MD. Vajira Minimally Invasive Surgery Unit, Department of Surgery, Faculty of Medicine Vajira Hospital, University of Bangkok Metropolis


Objective of technique
To help us perform the gastric pouch-jejunal limb anastomosis more easier.

Description of methods
The gastric pouch-jejunal limb anastomosis is usually done by circular staple in our institute. We use the instruments from commercial PEG set to facilitate the procedure. Under direct vision from the endoscope inside the pouch, The tiny hole is create by cautery from outside. The snare is passed through this hole into peritoneal cavity to retrieve the nilon loop which insert via the laparoscopic port. After the loop is bought out from the patient’s mouth, the anvil of the staple is fixed to this loop. The loop is drawn backward, so the anvil is introduced into the gastric pouch. The EEA staple shaft is inserted into peritoneal cavity via the extended port incision. The anvil is attached and approximated to the shaft, then the staple is fired. The completeness of the anastomosis is ensured.

We found that our technique help us save the time in doing the gastric pouch-jejunal limb anastomosis.

Session Number: Poster – Poster Presentations
Program Number: P448
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