We usually perform linear vertical side-to side gastro-jejunal anastomosis with tri-staple endo-GIA, and manual closure of the enterotomies.

I usually perform gastro-jejunal anastomosis with a linear stapler and by hands the enterotomy

side to side stapled Gastro jejunal anastomosis and Hand sewn closure of otmy with 2'0 vicryl or PDS ,(rarely V loc, ).All ways lateral corner stitch first and then single layer whole thickness continuous suture from medial to lateral.

www.medtube.net Prof pkreddy

Linear stapled and hand-sewn are commonly used.

We usually use linear stapled technique

We use a linear stapler technique especially if doing the procedure laparoscopically but I’ve also seen some of the older surgeons doing a double layer sutured anastomosis during open partial gastrectomy, I haven’t seen the circular stapler used in my practice

I use linear stapler during laparoscopic procedure

Regarding your first question - I think the most commonly performed anastomosis in a laparoscopic gastrectomy would be a stapled anastomosis with linear stapler. Some surgeons may be using a circular stapler and a fully hand-sewn anastomosis is also less common.

i personally prefer the linear stapler too, and closing the enterotomies with a barbed PDS suture, therefore linear stapler would involve a degree of suturing.

Regarding your 2nd question about advantages and disadvantages- linear stapler has the best of all the worlds. Even though the leak rate between the techniques doesnot differ significantly, a stapling device would take less time than hand-sewn and hence less anesthetic insult to the patient. Linear staplers are less traumatic to the patient than circular staplers, the latter would involve enlarging one of the ports to introduce the large head of the gun leading to a lot more pain postoperatively and higher incidence of bleeding and SSI. For circular guns, 25 or less sized staplers are associated with higher anastomotic strictures, therefore one should aim for a largers gun.

I believe these are stupid questions because everyone uses the technique to which he is attached