Laparoscopic MINI GASTRIC BYPASS

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Surgeon(s)/Speaker(s): Dr. Lakshmi Kona

Surgical Procedure: Bariatric-Mini Gastric Bypass

Location: Gleneagles Global Hospital Hyderabad

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Indexsteps

1. Enter the lesser sac at Crows feet : Enter the lesser sac at Crows feet

2. Horizontal staple stomach at Incisura : Horizontal staple stomach at Incisura.

3. Vertical sleeve over 36F : Vertical sleeve over 36F.

4. Loop GJ 200 cm from DJ : Loop GJ 200 cm from DJ.

5. Measuring bowel : Bowel Measurement

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port positions

1. Port Position MGB : Port Position MGB.

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precautionary_measures

1. SCD (Sequential compression Device) : For DVT prophylaxis

2. SCD (Sequential compression Device) : Secure strapping of patient

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pre_post_measures

1. Preoperative investigations : HOMOCYSTEINE :new:Haemogram :new:ELECTROLYTE PROFILE :new:HOMA IR :new:Liver Function Profile :new:Activated Partial :new:Thromboplastin Time (APTT) :new:INSULIN -FASTING SERUM :new:PHOSPHORUS SERUM :new:Calcium Total :new:TESTOSTERONE TOTAL :new:Thyroid Profile-1

2. Preoperative measures : Liquid diet for about 2 weeks @ 800 kcal per day :new:Pre operative optimization of co morbidities (eg: glycemic control , hypertension, hypothyroid etc) :new:Pre operative spirometry

3. Preoperative measures : Intravenous venous fluids. :new:DUF prophylaxis (SCD, Stockings) :new:Start thromboprophylaxis with after 6 hours :new:Early ambulation :new:Incentive Spirometry

4. Warning signs in the postoperative period : :new:Tachycardia :new:Hypotension :new:Drain output (constituency, amount) :new:Fever :new:Shortness of breath

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Surgical Instruments

1. Veress needle

2. 12 mm Trocar

3. 5 mm Trocar

4. 45 degree telescope

5. Harmonic Scalpel

6. Stapler

7. Suture

8. 9.8 mm Gastroscope

9. Grasper

10. Maryland Dissector

11. Energy source

12. Staple-line reinforcers

13. Orogastric tube

14. Bariatric Endostapler

15. Laproscopic 45 cm length instruments

16. Bougie 36 fr size

17. Liver Retractor

18. Visiports 12mm 3 nos