Laparoscopic Linear Stapled Running Enterotomy Closure in Roux-en-Y Gastric Bypass Using Absorbable Unidirectional Barbed Suture (Stratafix® 2/0).

Background: Laparoscopic running enterotomy closure for linear stapled Roux-en-Y gastric bypass (RYGB) may be enhanced by using unidirectional barbed sutures (Stratafix™ 2/0, Ethicon) as it eliminates the need for knot tying and assistance from a third hand.
Objectives: The objective of this paper is to present our technique using unidirectional barbed sutures (Stratafix™ 2/0, Ethicon).
Methods: After stapling the gastrojejunostomy, we start the closure of the residual enterotomy unidirectional from left to right (single, full-thickness layer) which is cut without a knot. For the jejunojejunostomy, the residual enterotomy is closed perpendicular from top to bottom in order to avoid iatrogenic stricture formation (single, full-thickness layer). No backstitches are performed.
Conclusions: We feel strongly that this technique might enhance running enterotomy closure for linear stapled RYGB.