Abstract
Background: The laparoscopic Roux-en-Y gastric bypass (LRYGBP) may be performed using a variety of methods. The purpose of this study was to learn how to perform the Roux-en-Y gastric bypass operation laparoscopically, using a porcine model. Materials and Methods: 11 domestic pigs (mean weight 47 kg) underwent LRYGBP. In 8 animals, a completely laparoscopic approach was attempted, while in 3 animals a hand-assist device was used. Techniques for anvil placement, pouch calibration, and limb-length measurement were evaluated. Animals were sacrificed at the end of the procedure, and operative results were recorded. Results: The hand-assist device restored tactile feedback but obscured visualization. The gastrojejunostomy leak rate was 64%, and the jejunojejunostomy leak rate was 73%. Anvil placement using transgastric and transoral methods was feasible. Calibrating the pouch with a Baker's tube was more accurate than using anatomical landmarks. Measuring limb-lengths using Babcock clamps was reliable with practice. Conclusion: The frailty of the porcine small intestine may limit one's ability to achieve intact anastomoses. Despite the anatomic limitations, the porcine model was well-suited for skill development and evaluation of techniques for performing the LRYGBP operation.
Original language | English (US) |
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Pages (from-to) | 46-53 |
Number of pages | 8 |
Journal | Obesity Surgery |
Volume | 11 |
Issue number | 1 |
DOIs | |
State | Published - 2001 |
Keywords
- Bariatric surgery
- Hand-assist device
- Laparoscopy
- Morbid obesity
- Porcine model
- Roux-en-Y gastric bypass
- Skill development
- Surgical education
ASJC Scopus subject areas
- Surgery
- Endocrinology, Diabetes and Metabolism
- Nutrition and Dietetics