Intraoperative endoscopic assessment of the pouch and XXXX during laparoscopic Roux-en-Y gastric bypass.

@entity1 @entity28 @entity548 @entity254 @entity260
As an advanced surgical procedure, laparoscopic Roux-en-Y gastric bypass (LRYGB) is associated with considerable morbidity, especially in the learning curve period. The aim of this study was to evaluate the role of endoscopy during LRYGB surgery in assessing the gastric pouch and @entity254 for air leak, @entity548 , and structure at the beginning of a bariatric surgery program. @entity1 who underwent LRYGB for morbid obesity between May 2008 and May 2009 were included in this study. After the completion of the @entity254 , an endoscopic examination was carried out. The transection line and @entity254 site were examined for @entity548 and patency and inspected for air leak under laparoscopic vision. Thirteen morbidly @entity28 @entity1 (mean body mass index, 48.0        6.8  kg/m(2)) were evaluated by endoscopic examination during the LRYGB operation. None of the cases had @entity548 at the transection line or @entity254 site. In two @entity1 , air leak test was positive and the @entity254 was reinforced with additional sutures. All the @entity1 , including those with positive air leak test, were discharged from the hospital with no leak complications. After a mean follow-up of 9.1        5.5  months, except for the @entity1 who underwent balloon dilatation, no other @entity1 had anastomotic stricture. Intraoperative endoscopy is invaluable in the assessment of @entity548 , anastomotic patency, and air leak during LRYGB, and it might be a helpful auxiliary tool to decrease morbidity during the learning curve period. Also, it helps solve intraoperative problems during the surgery so that @entity260 might be prevented.
