Roux-en-Y Gastric Bypass with Manual Intracorporeal Anastomoses in 3D Laparoscopy: Operative Technique

Area of Science:

• Minimally Invasive Surgery
• Bariatric Surgery
• Surgical Techniques

Background:

• Severe obesity requires effective treatments; Roux-en-Y gastric bypass is a common bariatric procedure.
• Traditional methods often involve staplers for anastomosis.
• Enhanced recovery after surgery (ERAS) protocols aim to optimize patient recovery.

Purpose of the Study:

• To present a novel 3D laparoscopic Roux-en-Y gastric bypass technique.
• To describe a completely handsewn intracorporal anastomosis method.
• To evaluate the safety and cost-effectiveness of this technique.

Main Methods:

• A 3D laparoscopic approach was used to create a 20 mL gastric pouch.
• Gastrojejunal and jejunojejunal anastomoses were performed using continuous sutures (resorbable V-Lock 3.0).
• All patients were managed under a bariatric ERAS protocol.

Main Results:

• The handsewn anastomosis technique was found to be safe and comparable to existing methods.
• Combining the technique with the ERAS protocol reduced postoperative pain.
• Patients were typically discharged within 48 hours.

Conclusions:

• Totally handsewn anastomosis in Roux-en-Y gastric bypass is a safe and effective technique.
• This method is cost-effective, avoiding the need for staplers.
• The technique, coupled with ERAS, enhances patient recovery and shortens hospital stays.