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4.2 Entero-enteral Anastomosis
Next, the ligament of Treitz is identified followed by
transection of a 50 cm length of the jejunal limb using
a linear stapler (length 45 mm, 3.5 mm staples). To ensure
that the anastomosis if free of tension, an incision
of approx. 5 cm is made in the mesenterium. The jejuno-
jejunal anastomosis is created approx. 70 – 150
cm from the site of gastrojejunostomy depending on
the patient’s BMI. A general rule of thumb may be that
the higher the BMI, the longer the alimentary limb
must be sized to fit.
Entero-enteral anastomosis (posterior wall by use of a stapler).