Linear technique of laparoscopic Roux-en-Y gastric bypass

The laparoscopic Roux-en-Y gastric bypass (LRYGB) is currently the most common procedure performed for treatment of morbid obesity in the United States. The technique reported in this chapter requires mastering of extra-corporeal and intra-corporeal laparoscopic suturing, but is safe, cost effective, and technically feasible. Use of the straight needle eliminates the challenge of proper needle orientation encountered with a curved needle. The linear technique is used to construct the gastrojejunostomy because it is time saving and relatively simple. An endoscopic ruler and bougie are used to ensure a consistent pouch size and alimentary limb length. This chaper demonstrates the use of preoperative preparation, and a meticulous surgical technique using the linear stapler, to perform a combined total of more than 1800 cases.