ABSTRACT
Since the advent of laparoscopic Roux-en-Y gastric bypass by Wittgrove et al, in 1993, the operation has generally been accorded high marks as to feasibility, when performed by skilled laparoscopic surgeons, and as to weight loss, when compared with the original operation performed using conventional open surgical techniques. Early series suggest that some improvement in the risk for wound complications (infection and hernia) may be possible; on the other hand, there may be a higher risk of gastrojejunal anastomotic leak and stomal stenosis. In addition, the method of gastrojejunal anastomosis continues to undergo revision, based on a widespread dissatisfaction with the original technique, described by Wittgrove et al, in which an EEA™ (Ethicon Division of Johnson and Johnson, New Brunswich, NJ) 21 mm French-guage anvil must be pulled per orum down the esophagus, using an endoscopicaUy positioned guide wire.
