Abstract
The technique used for R-OAGB/MGB is based on a 5-port approach . The gastric sleeve is dissected free from firm adhesion between the staple line and surrounding tissues, starting from the distal staple line and proceeding to the angle of His. The first step of R-OAGB/MGB involved a calibrated (36 F tube) sleeve using blue Endo GIA reloads removing all the excessive gastric tissue. For patients with previous LGB, the gastric band was freed from the surrounding capsule and adhesions and cut and extracted through the 15 mm port. The internal fibrous tissue between the band and the stomach was removed as well to prevent stenosis of the tube at this level. The gastric greater curvature was than completely freed starting at 4 cm proximal to the pylorus using LigaSure (Covidien, Minneapolis, MN, USA) along with the direct release of lower sac adhesions and scarring to the left crus. A sleeve gastrectomy was than performed as described above.
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