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Background <p>Laparoscopic Roux-en-Y gastric bypass (L-RYGB), a common procedure for treating obesity, requires a gastrojejunostomy (GJA). The most used techniques for GJA, namely, linear stapling and hand-sewing, have similar outcomes. Since GJA is time-consuming, optimizing GJA would provide a strategic opportunity to reduce surgical times.</p> <p>We describe a completely mechanical GJA (CM-GJA) to standardize its configuration and reduce the creation time of CJA. Additionally, we present our initial experience and learning curve with this technique.</p> Methods <p>Retrospective analysis with prospective follow-up of a cohort of 166 patients who underwent L-RYGB or conversion to L-RYGB in Antofagasta, Chile, from January 2020 to January 2023. Patients were divided into four chronological groups based on the date of surgery to evaluate the CM-GJA creation times, and the demographics, surgical aspects, complications, and percentage of excess BMI loss (%EBMIL) at 6&#xa0;months were analyzed.</p> Results <p>Average time for CM-GJA creation was 4&#xa0;min 34&#xa0;s. There was a significant reduction in CM-GJA creation time, from 4&#xa0;min 43&#xa0;s to 4&#xa0;min 24&#xa0;s (<i>p</i> &lt; 0.001). Mean BMI decreased from 41.30 to 30.71 after 6&#xa0;months; moreover, 82.5% of patients had a %EBMIL ≥ 50%, and 51.8% had a %EBMIL &gt; 65%. Strictures occurred in 1.8% of patients.</p> Conclusions <p>CM-GJA implementation in L-RYGB yielded an optimal clinical response, as shown by the procedural learning curve and patient outcomes. These findings suggest that CM-GJA not only reduces GJA creation times but may also enhance safety, supporting its broader adoption in clinical practice.</p>

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Completely Mechanical Gastrojejunal Anastomosis: A Novel Way to Perform Laparoscopic Gastric Bypass

  • 期刊论文

  • 发表日期：

    2025年8月6日

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  • Rodrigo Villagrán,
  • Antonio Mercandino,
  • Nelson Aros,
  • Nasser Eluzen,
  • Bárbara Carreño,
  • Mario Cariaga,
  • Fernanda Sanhueza-Olivares

摘要

Background

Laparoscopic Roux-en-Y gastric bypass (L-RYGB), a common procedure for treating obesity, requires a gastrojejunostomy (GJA). The most used techniques for GJA, namely, linear stapling and hand-sewing, have similar outcomes. Since GJA is time-consuming, optimizing GJA would provide a strategic opportunity to reduce surgical times.

We describe a completely mechanical GJA (CM-GJA) to standardize its configuration and reduce the creation time of CJA. Additionally, we present our initial experience and learning curve with this technique.

Methods

Retrospective analysis with prospective follow-up of a cohort of 166 patients who underwent L-RYGB or conversion to L-RYGB in Antofagasta, Chile, from January 2020 to January 2023. Patients were divided into four chronological groups based on the date of surgery to evaluate the CM-GJA creation times, and the demographics, surgical aspects, complications, and percentage of excess BMI loss (%EBMIL) at 6 months were analyzed.

Results

Average time for CM-GJA creation was 4 min 34 s. There was a significant reduction in CM-GJA creation time, from 4 min 43 s to 4 min 24 s (p < 0.001). Mean BMI decreased from 41.30 to 30.71 after 6 months; moreover, 82.5% of patients had a %EBMIL ≥ 50%, and 51.8% had a %EBMIL > 65%. Strictures occurred in 1.8% of patients.

Conclusions

CM-GJA implementation in L-RYGB yielded an optimal clinical response, as shown by the procedural learning curve and patient outcomes. These findings suggest that CM-GJA not only reduces GJA creation times but may also enhance safety, supporting its broader adoption in clinical practice.