carencia MIni gastricbypass #Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی

#pakistani Bariatric surgery #pakistani Weight Loss Surgery #Pakistani Obesity & Diabetic Surgery #المستشفی الایرانی دبی
Minigastric By pass step by step IMRAN ABBAS MD,DIBGS,FMIS,FWAMS,FASMBS CONSULTANT LAPROSCOPIC BARIATRIC SURGEON, DUBAI,UAE LIFE LINE HOSPITAL IRANIAN HOSPITAL MEDICAL SPECIALIST CENTRE
PATIENT POSITION
SUPINE
SEMILITHOTOMY
SEMISITTING POSITION
TROCAR POSITION
PORT A (10 mm optical) Just Left lateral To Linea Alba In male 10 cm from Xiphoid In female 15 cm from Xiphoid
PORT B 12 mm 10cm Left Lateral & Parallel to Port A
PORT C 5mm 3-4 cm below right costal margin at lateral rectus sheath
PORT D 5mm 1cm below xiphoid
PORT E 5mm Left Ant Axillary Line 3cm below costal margin


STEP ONE
Safe Entery By Optical Port Just Left Lateral To Linea Alba
Confirm Peritoneal Fold Before Enterence

Step Two
Liver Retraction
Holding The Liver With Locking Grasper With Grasping Soft Tissue At Right Crus


Step Three & four
His Angle Dissection
1cm Distal to EG Juntion
Much Helpful For Stapling Of Last Stapler
Rule out any Intestinal adhesion

STEP 5
Creation Of Lesser Omental Window
Begin at Crow,s Foot
Window Must be 2cm just attach with stomach wall
Adhesiolysis if any adhesion with pancreas


STEP SIX
1st Reticular Stapler From Port B
Use 4.5 mm Cartridge
Use Green,Gold,Purple,Black

STEP SEVEN
All Staplers From Port B
Making a wide long Gastric Pouch with the Guide on 36 F Bouggei
Cartridge 60mm
Cartridge Colour Blue,Golden,Purple

STEP EIGHT
Final Stapler From Port B
Cartrige Blue
Stay 1-1.5 cm lateral to EG Junction(Fat Pad)

STEP NINE
Gastrotomy mid point just posterior to 1st stapler line

STEP TEN
Identify Trietz Ligament
Intestinal Measurment Clock wise hand to hand
Measure 150 to 200 cm of Jejunum
Entrostomy


STEP 11
Gastrojejunostomy
Cartridge Blue 45mm,30mm
Thick arm of cartridge inside intestine
Never manipulate intestine aggressively
Retract down ward the gastric pouch if necessary
Posterior anastomosis,middle to medial of gastric pouch,distance B/W two stapler line must be more than 1cm,if less than 1cm than must be bury


STEP 12
Closure of gastrostomy/enterostomy
Suture PDS 2-0 blue colour needle 30mm

STEP 13
Air Leak Test
Control hemostasis
Check Stapler Line especially Remannant
Insert drain carrogate Drain
Control Port Site for bleeding

Bariatric Surgeon Dubai UAE #Weight Loss Surgeon Dubai UAE #Obesity Treatment Dubai #Diabetes

carencia MIni gastricbypass #Weight Loss Surgery #Iranian Hospital Dubai#المستشفی الایرانی دبی
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