[Jejuno-ileal bypass in the treatment of severe obesity: transverse or vertical approach?]

The criteria applicable to the selection of the approach route in the surgical management of essential gross obesity by means of a jejunal-ileal by-pass are discussed. Median vertical and transverse incision are compared in the light of early and late hypoxaemia in the immediate postoperative period; postoperative acidosis and alkalosis; rapidity; exposure; extendibility; tightness; postoperative pain; cosmetic results. A preference for the vertical approach is both stated and justified.