Laparoscopic gastric bypass

Background: The present report describes the technical details of laparoscopic bypass for morbid obesity. Methods: The laparoscopic approach was attempted in eight patients and completed in six. In these latter patients the stomach was divided with an endoscopic linear cutter (ETC 60 Ethicon), and a antecolic jejunal loop was brought to the proximal pouch and anastomosed by use of manual suture technique supported with locking clips for knotting substitutes [Lapra-Ty (Ethicon)]. Distal to the gastrojejunostomy a side-to-side enteroanastomosis was also performed. Results: Five patients in whom the laparoscopic procedure was completed had an unevenful postoperative period and a rapid recovery. However, one patient had a postoperative left-sided pleuropneumonia that required prolonged hospital stay. Of those who were converted, one was because of a large steatotic left liver lobe and another was due to a perforation of the small intestine. Conclusions: These early results indicate that gastric bypass for the treatment of morbid obesity can be safely performed with laparoscopic techniques. Further development in this field should be encouraged.