Johnson & Johnson Institute
Laparoscopic Roux-en-Y gastric bypass
Commonly used devices
Commonly used equipment
5 mm or 10 mm 30-degree laparoscope
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Insufflation needle
ENDOPATH™ Insufflation Needles
The ENDOPATH™ Pneumoneedle and Ultra Veress Insufflation Needles are surgical instrument used during minimally invasive procedures, particularly in laparoscopy, and are intended to establish pneumoperitoneum.1,2 The abdominal distension allows surgeons to see and operate on the internal structures more easily. Each device utilizes a spring-loaded, blunt stylet safety mechanism. Features of both devices include: 14-gauge stainless steel needle, attached at its proximal end to a plastic comfort handle containing a stopcock and a Luer lock connector for insufflating the abdominal cavity. The abdominal distension allows surgeons to see and operate on the internal structures more easily.1,2
Trocars
ENDOPATH XCEL™ Trocars
Trocars are the first point of contact into a patient during minimally invasive procedures and need to do many jobs - maximize visibility and maneuverability, enable surgical flow, and minimize exposure to pneumoperitoneum gas. ENDOPATH XCEL™ Trocars are designed to offer the control1,2A-D and consistency3-5E-G needed throughout the procedure from open to close.
Energy
HARMONIC™ 1100 Shears
When operating in tight spaces or near vital structures, precision is essential. HARMONIC™ stands unrivaled as the undisputed ultrasonic leader and proven to deliver minimal thermal impact on tissue1,2A with precise energy delivery.3,4 HARMONIC™ 1100 Shears, our most advanced ultrasonic device, delivers secure vessel sealing up to and including 7mm5-7, faster transection speeds, lower maximum blade temperatures, and more precise tissue dissection.8-12B
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Energy
ENSEAL™ X1 Curved Jaw Tissue Sealer
The ENSEAL™ X1 Curved Jaw Tissue Sealer, a part of our advanced bipolar ENSEAL™ portfolio, delivers secure sealing.1A This device has a curved tapered tip, and features simplified steps for use with one-handed2, 360-degree rotation3-5, separate seal and cut buttons4-5, and an efficient, ergonomic grip.2B
Staplers
ECHELON™ 3000 Stapler
The ECHELON™ 3000 Stapler was designed to accommodate each patient's unique anatomy, providing consistency across every staple line. It enables better access1A and more control2B over each transection, making it easier to tailor procedures to your patient's unique needs.
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Staplers
ECHELON CIRCULAR™ Powered Stapler
Leaks during surgery can lead to serious complications, especially in challenging cases. The ECHELON CIRCULAR™ Powered Stapler significantly reduced leaks at the staple line and produced greater perfusion compared to the Medtronic EEA™ Circular Stapler with Tri-Staple™ Technology.1,2A The device combines two breakthrough innovations—3D Stapling and Gripping Surface Technologies—on one consistent and reliable powered platform.
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Suture
MONOCRYL™ Plus Antibacterial (poliglecaprone 25) Suture
Surgical site infections (SSIs) are the most common type of hospital-acquired infection.1 Part of the Ethicon suture portfolio, MONOCRYL™ Plus Antibacterial Sutures provide the same handling and performance as traditional MONOCRYL™ (Poliglecaprone 25) Sutures while dependably providing antibacterial protection.2-9
Coated with triclosan, these absorbable sutures were associated with nearly 30% reduction in the risk of SSIs.10,11A Backed by the highest level of clinical evidence,8,12-16H these sutures offer an added layer of protection against the most common pathogens associated with SSIs in an in vitro study.2,4,5BC
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Staple line reinforcement
ECHELON ENDOPATH™ Staple Line Reinforcement
Experience easy application for OR efficiency with our ECHELON ENDOPATH™ Staple Line Reinforcement (SLR). It is designed to stay in place during tissue manipulation1,2A and features an added layer of protection to reinforce the staple line, helping keep your focus squarely on the patient and procedure.
Topical skin adhesive
DERMABOND™ PRINEO™ Skin Closure System
The DERMABOND™ PRINEO™ Skin Closure System offers a powerful, non-invasive alternative to traditional skin sutures and staples. It combines the strength, flexibility, and microbial protection of DERMABOND ADVANCED™ Topical Skin Adhesive with a secure, latex-free, self-adhering mesh to facilitate optimal skin closure and healing.1-7A In a clinical study, the DERMABOND™ PRINEO™ System was associated with a better cosmetic outcome than conventional suturing in skin closure. 8B
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Adjunctive hemostat
VISTASEAL™ Fibrin Sealant (Human)
Mimicking the body's clotting process, VISTASEAL™ Fibrin Sealant (Human) forms a rapid, adherent, and durable clot, even in patients with challenging coagulation profiles.1-4 A simplified preparation process offers flexible application—you can easily drip or spray it, adjusting seamlessly to your surgical approach.
VISTASEAL™ can be thawed in the refrigerator (2-8°C, 36-48°F) and stored in the refrigerator for 7 days after thawing if it remains sealed in the original packaging.1
References
VISTASEAL™ Fibrin Sealant (Human) IMPORTANT SAFETY INFORMATION
INDICATION
VISTASEAL™, a fibrin sealant, is indicated as an adjunct to hemostasis for mild to moderate bleeding in patients undergoing surgery when control of bleeding by standard surgical techniques (such as suture, ligature, and cautery) is ineffective or impractical. VISTASEAL™ is effective in heparinized patients.
CONTRAINDICATIONS
Do not inject directly into the circulatory system.
Do not use for the treatment of severe or brisk arterial bleeding.
Do not use in patients with history of anaphylaxis or severe systemic reactions to human blood products.
Do not use VISTASEAL™ for spraying unless the minimum recommended distance from the applicator tip to the bleeding site can be achieved.
WARNINGS AND PRECAUTIONS
Thromboembolic events may occur if VISTASEAL™ is administered intravascularly.
Hypersensitivity reactions can occur.
May carry a risk of transmitting infectious agents, e.g., viruses, the variant Creutzfeldt-Jakob disease (vCJD) agent and, theoretically, the Creutzfeldt-Jakob disease (CJD) agent.
ADVERSE REACTIONS
The most common adverse reactions (reported in >1% of patients) were procedural pain, and nausea.
For complete indications, contraindications, warnings, precautions, and adverse reactions, please reference full package insert.
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© Johnson & Johnson and its affiliates 2024
For complete indications, contraindications, warnings, precautions, and adverse reactions, please reference full package insert.
Christopher Joe Northup, MD prepared this procedure guide on behalf of Johnson & Johnson and its affiliates. The procedure guide reflects the opinions of the individual presenter, and the steps described may not encompass the complete steps of the procedure. Additionally, other surgeons may prefer different techniques, approaches, etc., as individual surgeon experience in his/her clinical practice, as well as patient needs, may dictate variation in procedure steps.
Before using any medical device, review all labeling, including without limitation; the Instructions For Use (IFU), and relevant package inserts with particular attention to the indications, contraindications, warnings and precautions, and steps for use of the device(s).
This presentation is not accredited for CE/CME.
Christopher Joe Northup, MD is compensated by and presenting on behalf of Johnson & Johnson and its affiliates and must present information in accordance with applicable regulatory requirements.
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