Facilitated vertical gastric pouch construction for gastric bypass

Background: Efforts to simplify and reduce surgical risk of gastric pouch construction in super obese patients have led to technical changes which are described. Methods: Operative technique of vertical gastric pouch construction and hand-sewn Roux gastrojejunostomy are described. Results: 171 patients with average BMI = 55 have undergone gastric bypass with the modified technique, a majority with double stapling of the gastric pouch. Staple-line dehiscence is reduced and operative morbidity is limited. Conclusions: Technical changes described have shortened operative time, reduced intraoperative frustrations, and produced limited frustrations, morbidity.