P-53 Low incidence of petersen's hernia after laparoscopic Roux-en-Y gastric bypass with a 2-stitch technique

hundred sixty seven were performed with the 21mm OrVilTM device and 502 were performed using either a 25mm PPCCEATM transgastric approach ( n 245) or a 25mm OrVilTM device ( n 257). The OrVilTM device was successfully deployed in all cases. There were no leaks nor need for secondary intervention due to bleeding in the 21mm OrVilTM group. Forty six patients (8%) suffered a gastrojejunostmy (GJ) stricture in the 21mm OrVilTM group. Of these patients, 8 (17%) required a revision of their GJ secondary to refractive strictures and ulcers. In patients where the 21 OrVilTM was not used, 40 patients (8%, 40/502) developed a GJ stricture. No patient required a revision of their GJ in the non-21mm OrVilTM group (p 0.006). Conclusion: The 21mm OrVilTM can be safely deployed and results in acceptable leak rates with low bleeding related complications. Strictures following its use seem to be more refractive to endoscopic intervention and results in a significantly higher GJ revision rates (p 0.006). While this observation may be related to anvil size and circular stapler height, future studies are warranted.