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Patient with BMI 62 &weight 180.
Dissection at lesser curve of stomach
1st stapler fired using a green reload
On a bougie Loose pouch is made
On the lesser curve of stomach subsequent firing is done &a loose pouch is made
Linear cutting stapler used to make a pouch at lesser curve of stomach
To release the fundus
Tunneling is done and gold finger is introduced
Bypassed stomach is free from the pouch
Gastrotomy over a bougie by a hook
Enterotomy is done 200 cm from a D J Flexure
Staple fired after aligning the gastric poch with the jejunum
Wide anastomoses between gastric pouch and jejunum to prevent stricture formation
On bougie few stay sutures are taken which helps in firing stapler
Stay sutures which helps in firing the stapler
Gastroenterotomy is closed
Fully stapled gastrojejunostomy
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