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Related Experiment Video

Updated: Jul 5, 2026

Robotic Taj Mahal Hepatectomy for Hilar Cholangiocarcinoma

Robotic Taj Mahal Hepatectomy for Hilar Cholangiocarcinoma

Published on: July 14, 2022

Ante-hepatic gastrojejunostomy.

George S Ferzli¹, Eric D Edwards

¹Department of Surgery, Lutheran Medical Center, Brooklyn, NY, USA. gferzli@aol.com

American Journal of Surgery

|April 22, 2008

Summary

Laparoscopic Roux-en-Y gastric bypass for morbid obesity is gaining popularity. A new technique improves visualization of the gastroesophageal junction, overcoming challenges posed by enlarged livers during surgery.

Area of Science:

Bariatric surgery
Minimally invasive surgery
Surgical anatomy

Background:

Morbid obesity surgical treatment is increasing.
Laparoscopic techniques are driving popularity in bariatric surgery.
A common surgical challenge is liver enlargement obscuring the angle of His.

Purpose of the Study:

To describe a novel technique for improved exposure of the angle of His.
To facilitate safe and effective gastric pouch creation and gastrojejunostomy during laparoscopic Roux-en-Y gastric bypass.

Main Methods:

Description of a specific surgical maneuver for liver retraction.
Focus on achieving optimal visualization of the gastroesophageal junction.
Utilizing existing trocar sites to minimize invasiveness.

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Colonial Wig Pancreaticojejunostomy

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Main Results:

The described technique provides safe and excellent exposure of the gastroesophageal junction.
Overcomes the obstacle of a massively enlarged liver.
Avoids drawbacks of existing methods like bleeding and extra trocar insertion.

Conclusions:

This technique offers a safe and effective solution for visualizing the angle of His.
It simplifies a critical step in laparoscopic Roux-en-Y gastric bypass.
Enhances the safety and efficiency of bariatric surgical procedures.