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Totally Extramucosal Hand-Sewn Robotic Gastrojejunostomy for Roux-en-Y Gastric Bypass
Miljana Vladimirov1, Firas Makdesi1, Ayman Georgios1
1Department of Surgery, Medical School and University, Medical Center OWL-Campus Lippe, Bielefeld University, Detmold, Germany. (Drs. Vladimirov, Makdesi, Georgios, Madarasz, and Hoeppner).
Summary
Robotic Roux-en-Y gastric bypass using a single-layer hand-sewn gastrojejunostomy is safe and feasible. This technique demonstrated no leaks or bleeding in 73 procedures, with one stricture successfully treated.
Area of Science:
- Bariatric Surgery
- Minimally Invasive Surgery
- Robotic Surgery
Background:
- Roux-en-Y gastric bypass is a key metabolic-bariatric procedure.
- Minimally invasive approaches like laparoscopy and robotic assistance are common.
- Robotic platforms offer advantages for hand-sewn gastrojejunostomy, ensuring consistent technique.
Purpose of the Study:
- To describe a single-layer, continuous, extramucosal hand-sewn gastrojejunostomy technique.
- To evaluate the feasibility and safety of this technique during robotic Roux-en-Y gastric bypass.
- To present perioperative outcomes of primary and revisional procedures.
Main Methods:
- A single bariatric surgeon performed robotic Roux-en-Y gastric bypass using the da Vinci X, Xi, or 5 platforms.
- A specific single-layer, continuous, extramucosal hand-sewn gastrojejunostomy technique was employed.
- Perioperative outcomes were analyzed for 73 consecutive cases.
Main Results:
- 73 procedures (34 primary, 39 revisional) were completed between April 2024 and January 2026.
- No anastomotic leaks or gastrojejunostomy-related bleeding were reported.
- One anastomotic stricture occurred within 30 days and was managed with endoscopic dilation.
Conclusions:
- The described robotic hand-sewn gastrojejunostomy technique is feasible and safe.
- This technique can be reliably applied in both primary and revisional Roux-en-Y gastric bypass.
- The study supports the use of this method for consistent surgical outcomes.
