Alternative Method of Mesenteric Defect Closure after Roux-en-Y Gastric Bypass

Roux-en-Y gastric bypass is the gold standard for weight loss surgery. This procedure creates two to three mesenteric defects, depending on ante-colic versus retro-colic technique. Current literature supports mesenteric defect closure, but there is no consensus on how to best close these defects. Described options include running separate suture lines for each defect, or employing endoscopic staplers for defect closure.

This is a video/dynamic manuscript on operative technique.

We describe an alternative technique that does not require an extra laparoscopic instrument and is more efficient than traditional suture lines due to less suturing.

The technique maintains low gastric bypass complication rates by closing mesenteric defects, while keeping intra-operative costs low, and minimizing time spent on the defect closures.