OPERATION: Laparoscopic Single Anastomosis Gastric Bypass (SAGB)
ANAESTHETIC: General anaesthesia
INDICATION: Morbid obesity
FINDINGS: Large fatty liver. Adhesions from previous abdominal surgery.
PROCEDURE:
3x 12mm, 2x 5mm ports. Primary port by Optiview technique.
Endoflex retractor to left lobe of liver.
Perigastric dissection along lesser curve to enter lesser sac.
Long narrow gastric pouch fashioned along lesser curve using powered Echelon 4x60mm blue staplers.
Sutured gastrojejunal anastomosis performed with 2-0 PDS over 33F orogastric tube.
150cm biliopancreatic limb.
Methylene blue leak test - no leak. Haemostasis confirmed.
CLOSURE:
Subcuticular Monocryl to skin. 40ml levobupivacaine infiltrated.
POST-OPERATIVE INSTRUCTIONS:
Sips and fluids as per bariatric protocol.
VTE prophylaxis. Chest physiotherapy. Early mobilisation.
IV proton pump inhibitor. Regular IV analgesia and antiemetics.