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Title
1. Endoscopy/Port Placement
2. Lysis of Adhesions and Hiatal Dissection
3. Vagotomy
4. Hiatal Hernia Repair
5. Division of Roux Limb
6. Partial Gastrectomy/Resection of Ulcer
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a. Remove Adhesions and Mesentery
b. Dissection of Stomach
c. Division of Gastric Remnant
d. Dissection of Remnant Off of Pouch
e. Dissection of Remnant/Pouch/Roux Limb Confluence (Resection of Ulcer)
f. Completion of Remnant Dissection
7. Rerouting of Roux Limb
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a. Oversew Staple Line of Remnant
b. Mobilize Jejunal Mesentery
c. Evaluation of Jejunal Anastomosis
d. Evaluation of Jejunal Common Channel
e. Division of Attachments of Roux Limb to Mesocolon
f. Identification of Ligament of Treitz/Creation of Mesocolonic Window
g. Passage of Jejunum through Transverse Mesocolon
8. New GJ Anastomosis
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a. First Layer of Anastomosis (Posterior Outer Layer)
b. Second and Third Layers of Anastomosis (Posterior and Anterior Inner Layers)
c. Fourth Layer of Anastomosis (Anterior Outer Layer)
9. Endoscopy for Testing of Anastomosis
10. Reducing the Jejunum and Closing Petersen's Defect
11. Revision of JJ Anastomosis
12. Retrieving the Specimen from the Abdominal Cavity
13. Closure
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Approach to Marginal Ulceration Following RYGB Surgery: Laparoscopic Excision of the Marginal Ulcer and Retrocolic, Retrogastric Rerouting of the Roux Limb with Truncal Vagotomy and Hiatal Hernia Repair
Deborah D. Tsao, BS
1
;
Janey Sue Pratt, MD
2
1
Stanford University School of Medicine
2
Massachusetts General Hospital
Tags:
General Surgery
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Authors
Deborah D. Tsao, BS
Janey Sue Pratt, MD
Filmed At:
Massachusetts General Hospital
Article Information
Publication Date
11/14/2024
Article ID
25
Production ID
0104
Volume
2024
Issue
25
DOI
https://doi.org/10.24296/jomi/25