The surgical approach was described in our previous article (18 (link)).
All patients were screened preoperatively by a multidisciplinary bariatric team, and written informed consent was obtained. Esophagogastroduodenoscopy, assessment for sleep apnea, and gallstones using ultrasonography were performed. Patients with gallstones underwent a concomitant cholecystectomy.
Of interest, our anastomotic technique changed over time, going from linear stapling to totally hand-sewn anastomosis. This change reflects a modification in the surgical habits over the period of the study. In the mechanical anastomotic technique, an antegastric end-to-side 3-cm gastrojejunostomy (GJ) anastomosis was created with a 45-mm linear stapler and the stapler opening was closed by means of a STRATAFIX™ (Ethicon Endo-Surgery, Inc., Cincinnati, OH, USA) running suture. In the hand-sewn anastomotic technique, an end-to-side GJ anastomosis of 2 cm in diameter was created with two STRATAFIX ™ full-thickness running sutures.
All patients received subcutaneous thromboprophylaxis with low-molecular-weight-heparin (LMWH) the day before and 6 h after surgery, according to their body weight and until 30 days after discharge. We allowed free liquid intake on postoperative day 0 and introduced a pureed diet on postoperative day 1. After adequate liquid intake and pain control, patients were discharged home.
All patients were screened preoperatively by a multidisciplinary bariatric team, and written informed consent was obtained. Esophagogastroduodenoscopy, assessment for sleep apnea, and gallstones using ultrasonography were performed. Patients with gallstones underwent a concomitant cholecystectomy.
Of interest, our anastomotic technique changed over time, going from linear stapling to totally hand-sewn anastomosis. This change reflects a modification in the surgical habits over the period of the study. In the mechanical anastomotic technique, an antegastric end-to-side 3-cm gastrojejunostomy (GJ) anastomosis was created with a 45-mm linear stapler and the stapler opening was closed by means of a STRATAFIX™ (Ethicon Endo-Surgery, Inc., Cincinnati, OH, USA) running suture. In the hand-sewn anastomotic technique, an end-to-side GJ anastomosis of 2 cm in diameter was created with two STRATAFIX ™ full-thickness running sutures.
All patients received subcutaneous thromboprophylaxis with low-molecular-weight-heparin (LMWH) the day before and 6 h after surgery, according to their body weight and until 30 days after discharge. We allowed free liquid intake on postoperative day 0 and introduced a pureed diet on postoperative day 1. After adequate liquid intake and pain control, patients were discharged home.
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