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Updated: May 26, 2026

A Protocol for Roux-en-Y Gastric Bypass in Rats using Linear Staplers
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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).

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|May 25, 2026
PubMed
Summary
This summary is machine-generated.

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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.
Keywords:
Extramucosal anastomosisHand-sewn gastrojejunostomyMetabolic bariatric surgeryRobotic surgeryRoux-en-Y gastric bypass

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Last Updated: May 26, 2026

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  • 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.