Technical considerations for transabdominal loading of the circular stapler in laparoscopic Roux-en-Y gastric bypass

Background Laparoscopic Roux-en-Y gastric bypass is being undertaken with increasing frequency. We describe a technique for introducing the anvil of the circular stapler using a totally transabdominal approach. Methods One hundred consecutive patients underwent laparoscopic Roux-en-Y gastric bypass in a university-affiliated teaching hospital. Results The cardiojejunostomy was constructed in all 100 patients using the circular stapler with no complications. No anastomotic leaks were detected postoperatively. Conclusions The totally transabdominal approach for introducing the anvil of the circular stapler into the gastric pouch is safe and feasible.