About Video

This video demonstrates the technical details of laparoscopic access of the excluded stomach and performance of an ERCP through this access port. Operative procedure: A 12 mm or 5 mm camera trocar is placed in standard fashion just to the left of midline. Two 5 mm trocars are placed in the right side. Another 5 mm trocar is placed in the left side. A gastrotomy is performed in the excluded stomach and the 12 mm balloon trocar or a 15 mm trocar is introduced through the gastrotomy. If a 12 mm balloon trocar is used then no fixation to the stomach is required. The 12 mm trocars only accommodate the older ERCP scopes. However, if a standard ERCP scope is used then a 15 mm trocar is required to accommodate the scope. The 15 mm trocar does not come with a self-retaining balloon configuration at this time and so the trocar is fixed to the stomach with a purse string suture with a 2-0 Vicryl. The surgical field is then draped with a hole cut out in the drape to accommodate the 12 mm trocar in the excluded stomach and the ERCP is completed. The gastrotomy is closed in two layers with a 2-0 Vicryl suture. This completes the procedure.