Society for Surgery of the Alimentary Tract

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Notes-Assisted Roux-en-Y Gastric Bypass
Monika E. Hagen^*¹, Francois Pugin¹, Oliver J. Wagner², Paul Swain³, Nicolas C. Buchs¹, Priya a. Jamidar⁵, Margherita Cadeddu⁴, Jean Fasel⁶, Philippe Morel¹
¹Digestive Surgery, University Hospital Geneva, Geneva, Switzerland; ²Department of Visceral and Transplantation Surgery, University Bern, Bern, Switzerland; ³Imperial College, London, United Kingdom; ⁴Department of Surgery, McMaster University, Hamilton, ON, Canada; ⁵Section of Digestive Diseases, Yale University, New Haven, CT; ⁶Division of Anatomy, University Geneva, Geneva, Switzerland

BACKGROUND: NOTES-assisted Roux-en-Y gastric bypass (RYGB) might offer certain advantages, but the technical feasibility is unknown.METHODS AND DESIGN: We have performed NOTES-assisted RYGB in 4 human cadavers. VIDEO: The video shows pouch creation using a flexible gastroscope introduced transvaginally. Articulated linear staplers placed transumbilically transect the stomach. Measurement of small bowel is done with flexible and rigid graspers. A flexible transesophageal stapler is used for the gastrojejunostomy, a linear stapler for the jejuno-jejunal anastomosis. CONCLUSION: The video demonstrates the technical feasibility of RYGB in human cadavers using a NOTES-assisted approach.

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