The Scopinaro Biliopancreatic Derivation
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In this procedure,the trocars are placed as for the duodenal switch procedure.
Stage 1
The surgeon stands to the left of the patient. The patient is placed in steep Trendelenburg while the surgeon takes place to the left of the patient. The distal ileum is located and snapped at the ileocaecal valve by a grasper with a mark at 5 cm and 75 cm are measured from this spot. This site is marked by a stitch. Another 175 cm are now measured proximally. This spot is again marked by a stitch in a different color. The bowel just proximal to this last mark is now anastomosed to the bowel at the first mark. This anastomosis is performed by one or two firings of the linear stapler, white load. The introduction opening is closed by a running suture of Vicryl 2/0. The mesentery gap at the level of the anastomosis is closed by a running suture of Prolene 2/0. The bowel between the anastomosis and the 250 cm mark is now cut by another firing of the linear stapler, white load.