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38 With advances in instrument design, even easier techniques may become available. Over the last 20 years, it has become obvious that this technique works because a lesser curvature tube of stomach has the best muscular support and stays functionally stable. 39 stomal obstruction and in some instances, to erosion of the medical device (material) into the stomach lumen. FIGURE 2-12 The silastic ring gastroplasty. 37 38 FIGURE 2-13 A. Creation of the Mason vertical-banded gastroplasty (VBG) with bougie in the esophagus and stomach to help calibrate the width of the pouch by dispensing the line of staples tightly against the tube.
37 suring the distance from the esophagogastric junction. 5 inches) in diameter (Figure 2-13) as the restricted neostoma at the end of the vertical tube created by the stapler. Alternatively, a linear stapling device that has the capacity to place four to six rows of staples and then cut parallel in the middle of the rows can be used to divide the vertical pouch from the rest of the fundus (Figure 2-13B). This approach creates a more permanent scar than placing staples without cutting the pouch off from the rest of the stomach.
Hess DW, Hess DS. Biliopancreatic diversion with a duodenal switch. Obes Surg 1998;8:267â 282. 18. Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg 2000;10:514â 523. 19. Buchwald H, Varco RL. A bypass operation for obese hyperlipidemia patients. Surgery 1971;70:62â 70. 47 44 45 20. Buchwald H, Varco RL, Matts JP, et al. Effect of partial ileal bypass surgery on mortality and morbidity from coronary artery disease in patients with hypercholesterolemia.
