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Early experience with computer-mediated flexible circular stapling technique for upper gastrointestinal anastomosis
Anne Waage1, Michel Gagner, John J Feng
1Mount Sinai School of Medicine, Department of Surgery, Division of Laparoscopic Surgery, New York, NY 10029, USA.
Obesity Surgery
|March 13, 2003
Summary
This study found that using the SurgASSIST device for laparoscopic bariatric surgery anastomoses was safe and effective. Direct anvil placement via duodenotomy is recommended for duodenoileostomies, while transoral passage is suitable for gastro-jejunostomies.
Area of Science:
- Bariatric Surgery
- Minimally Invasive Surgery
- Surgical Devices
Background:
- Proximal anastomosis creation is crucial for laparoscopic biliopancreatic diversion with duodenal switch (LBPD-DS) and Roux-en-Y gastric bypass (LRYGBP).
- Assessing novel stapling devices is vital for improving surgical outcomes.
Purpose of the Study:
- To evaluate the safety and efficiency of a flexible, computerized, circular stapling device for proximal anastomosis in bariatric bypass procedures.
- To compare different approaches for device utilization.
Main Methods:
- Prospective monitoring of the SurgASSIST stapling device in 10 patients undergoing LBPD-DS or LRYGBP.
- Review of patient charts to assess anastomosis success, complications, and procedure time.
Main Results:
- Successful construction of 9 out of 10 proximal anastomoses (2 gastro-jejunostomies, 7 duodeno-ileostomies) with no leakage.
- Transpyloric passage of the device was difficult in 2 patients; direct duodenotomy anvil placement was successful in 5.
- Median anastomosis time was 19 minutes; no postoperative complications were observed.
Conclusions:
- The SurgASSIST device is feasible and safe for laparoscopic anastomoses in bariatric bypass surgery.
- Direct anvil placement via duodenotomy is preferred for duodenoileostomies; transoral passage is suitable for gastro-jejunostomies.
- Further trials are needed to compare SurgASSIST with existing devices.