Robotic-assisted mini gastric bypass
Epublication WebSurg.com, Dec 2012;12(12). URL: http://websurg.com/doi/vd01en3763
Amongst bariatric procedures, mini gastric bypass has been described by Rutledge in 2001 with the objective of simplifying the gastric bypass technique (1). Mini gastric bypass only requires one anastomosis instead of 2 and should reduce complications related to the anastomosis at the foot of the loop in a conventional gastric bypass procedure. A few specificities should be pointed out. The gastric pouch is longer and more narrow. The landmark used to start the gastric division corresponds to the area separating the body of the stomach from the antrum at the level of the angulus. The biliary limb is also much longer and should reach 2cm in order to avoid the undiluted biliary fluid effects on the anastomosis. In this intervention, it is crucial to closue Petersen’s defect between the mounted loop and the transverse mesocolon. According to Himpens, this procedure could well reduce the incidence of hypoglycemias that might occur after a gastric bypass. This video outlines the different steps of the intervention. The use of a surgical robot allows to very easily perform a manual gastrojejunostomy. (1). Rutledge, R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg 2001;11:276-80.