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Gastric Shunting
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Hemorrhage into the lumen of interintestinal anastomosis after gastric shunting according to Roux
The author: Evdoshenko V.V. and Fedenko V.V.
Hemorrhage into the lumen of interintestinal anastomosis after gastric shunting according to Roux. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation (2017).
Hemorrhage from the interintestinal anastomosis as complication after bariatric operation for gastric shunting according to Roux is rarely met. In case of continuing hemorrhage a repeated laparoscopy is performed, then revision of anastomosis is done and the source of hemorrhage is liquidated. It should be done in this way, as the use of flexible endoscopy for hemostasis is difficult to use, while using a standard equipment. In this case they have removed suture from anastomosis. Blood clot is visualized that is fixed to the source of hemorrhage. Hemostasis is fulfilled, using EndoStitch apparatus.
The alternative version of gastric shunting with one anastomosis. Totally manual anastomosis, using EndoStitch apparatus, behind the stomach and behind the colon
The author: Evdoshenko V.V and Fedenko V.V.
The alternative version of gastric shunting with one anastomosis. Totally manual anastomosis, using EndoStitch apparatus, behind the stomach and behind the colon. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation (2017).
In standard gastric shunting with one anastomosis the operation is performed so that the small colon is in front of the colon and in front of the stomach. In case of extreme obesity and extensive size of omentum this way of performing an operation presents difficulties, problems can develop because omentum will interfere with anastomosis-it can be stretched by omentum. Suggested alternative technique implies that the small colon and “small stomach” should come closer, using the shortest way, and, thus, complete absence of any stretching.
Internal hernia after gastric shunting –Roux-en -Y gastric bypass
The author: Евдошенко В. В. и Феденко В. В.
Internal hernia after gastric shunting –Roux-en -Y gastric bypass. D-r Evdoshenko V.V. and D-r Fedenko V.V. are performing an operation.
One of the complications after gastric shunting – Roux-en-Y gastric bypass- is a formation of the internal hernia near the window of mesocolon. This window is created for pulling the loop of “Roux colon” into the superior part of the abdomen. Closure of that window at the end of operation is compulsory. Nevertheless, the closure sometimes is not efficient, and the situation is complicated by development of the internal hernia. Clinically it is manifested by intermitting intestinal obstruction, that within some period of time will be progressing, and the total obstruction will take place later on. This operation demonstrates the situation when the small colon is almost completely shifted into the cavity of omentum bursa through mesocolon window. So, the small colon has been shifted into proper position, open defect is stitched by continuous suture.
Gastric shunting – Roux-en-Y gastric bypass-for morbid obesity
The author: A.Forgione
Gastric shunting – Roux-en-Y gastric bypass-for morbid obesity. Professor A.Forgione is performing an operation (2016).
In this video the technique of bariatric operation – Roux-en-Y gastric bypass for morbid obesity is demonstrated. At the first stage the positioning of troacars is presented. For tissue dissection a 5 mm Harmonic Scalpel Ethicon instrument is used. Stitching of the colon and stomach is performed by a 60 mm Endo GIA MEDTRONOC COVIDIEN apparatus with white and blue casettes. Gastrointestinal anastomosis is formed by circular stitching apparatus.
