The gastrojejunostomy in laparoscopic Roux-en-Y gastric bypass

Many techniques for creating the gastrojejunal anastomosis while performing laparoscopic gastric bypass in obese patients have been described. The stapled anastomoses comprise the circular stapler technique, using either a 21- or a 25-mm anvil, and the linear stapler technique. The handsewn anastomosis, which seems to offer some advantages over the mechanical technique, is being performed with increased frequency. The three techniques are described here and discussed in the light of our own experience.