A 25 years male patient came with complaints of vomiting after having food sometimes without or with food. Weight loss since few months. Patient was evaluated in out-patient department and advised upper endoscopy. Dr Amit Gharat, senior medical gastroenterologist performed the endoscopy which showed narrowing of the pyloric region. A diagnosis was made of gastric outlet obstruction. She was advised for surgery and both open or laparoscopic surgery options, advantages and disadvantages discussed. Patient decided to undergo laparoscopic surgery. All necessary preoperative blood investigations, X-ray Chest, and ECG.
The gentleman was admitted one day prior to the surgery. Stomach lavage was given and preparations done for Laparoscopic Gastro-Jejunostomy surgery. In this surgery, the stomach and small bowel are aligned with stay sutures. A small opening is made on the stomach and small bowel to enable entry of the stapler. On firing the stapler, the blade within divides the stomach and the small intestine simultaneously. In the same firing, the rows of staples on the device join the cut ends of the stomach and the small bowel. The small opening made for the stapler is closed using sutures. This surgery allows food to pass from the stomach into the small intestine, thus providing relief of symptoms. This surgery was performed through 3 small incisions – one 12 mm for the stapler and two 5 mm. Closure of the wound done with absorbable stitches and waterproof dressing.
The gentleman was allowed liquids after 48 hours and gradually progresses to full liquids and soft diet. He was discharged five days after the surgery.
He is doing well on follow up, with weight gain of 5 kgs in 2 months.