Linear vs. Circular Stapled Gastrojejunal Anastomosis in Bariatric Laparoscopic Gastric Bypass Surgery in Switzerland

NCT07483957 | Completed

• 1 other identifier: RYGB linear vs. circular
• Study Type: observational
• Target: 21,375
• Locations: 1 country
• Sites: 1

Brief Summary

Bariatric surgery has become one of the preferred options in treatment of severe obesity and its comorbidities in the Western world. In Switzerland, the approximate 5000 annual bariatric operations are performed exclusively in centres certified by the "Swiss Society of Study of Morbid Obesity and Metabolic Disorders (SMOB)". Among the different bariatric surgical procedures, the laparoscopic gastric bypass remains one of the most frequently performed operations. A critical step of this operation is the creation of the gastrojejunal anastomosis. This can be done using either a linear or a circular stapler. The optimal method continues to be discussed in current academic research. The linear anastomosis technique seems to be more feasible, uses smaller incisions and is therefore faster performed. The circular anastomosis technique benefits from a standardised diameter of the anastomosis with consecutive higher reproducibility. No difference in long-term weight loss have been described for these two techniques until today. The linear technique has been linked to marginal ulcers, while the circular technique has been associated with higher rates of stenosis and incisional hernia. The associations with other long-term adverse events such as internal hernias remain under discussion. However, according to several international analyses, the linear technique seems to have favourable short-term outcomes with shorter operation time and lower rates of wound complications and postoperative bleeding. Both techniques are used in Switzerland but Swiss national data on this topic is scarce. Given the high annual case volume of bariatric surgery in Switzerland and the inconsistent international evidence, a systematic comparison of these two techniques is of relevance. This retrospective registry study provides Swiss national data on short-term postoperative outcomes after elective laparoscopic Roux-en-Y gastric bypass from 2015 to 2022. It aims to compare the linear vs. circular gastrojejunal anastomosis in terms of postoperative short-term postoperative, reoperation rate, and length of hospital stay.

Conditions

Bariatric Surgery (Gastric Bypass)

Outcome Measures

Primary Outcomes (1)

• Overall complications

  Periprocedural

Secondary Outcomes (7)

• Individual complications

  Periprocedural

• Reoperation

  Periprocedural

• Length of hospital stay

  up to 4 weeks

• Time trend age

  Between 2015 and 2022

• Time trend CCI

  Between 2015 and 2022

Study Arms (2)

Linear

Elective laparoscopic Roux-en-Y gastric bypass with linear gastrojejunal anastomsis

Procedure: Linear anastomosis

Circular

Elective laparoscopic Roux-en-Y gastric bypass with circular gastrojejunal anastomsis

Procedure: Circular anastomosis

Interventions

Linear anastomosis PROCEDURE

A linear stapled anastomosis was selected based on the Swiss Classification of Operations (CHOP) code 00.9A.13 or 00.9A.14.

Linear

Circular anastomosis PROCEDURE

A circular stapled anastomosis was selected based on the Swiss Classification of Operations (CHOP) code 00.9A.11 or 00.9A.12.

Circular

Eligibility Criteria

• Age: 20 Years+
• Sex: all
• Age Groups: Adult (18-64), Older Adult (65+)
• Sampling Method: Non-Probability Sample

Study Population

All patients with gastric bypass surgery in Switzerland between 2015 and 2022

You may qualify if:

• Elective laparoscopic Roux-en-Y gastric bypass

You may not qualify if:

• Incomplete documentation
• Age under 20 years
• Other hospitals than general or surgical hospitals
• Omega-loop gastric bypass
• Emergency admission
• No stapler coded
• Open access

Sponsors & Collaborators

• Cantonal Hospital of St. Gallen: lead

Study Sites (1)

HOCH Health Ostschweiz, Kantonsspital St.Gallen

Sankt Gallen, 9000, Switzerland

Location

Study Design

• Study Type: observational
• Observational Model: COHORT
• Time Perspective: PROSPECTIVE
• Target Duration: 90 Days
• Sponsor Type: OTHER
• Responsible Party: PRINCIPAL INVESTIGATOR
• PI Title: Principal investigator

Study Record Dates

• First Submitted: March 5, 2026
• First Posted: March 19, 2026
• Study Start: January 1, 2015
• Primary Completion: December 31, 2022
• Study Completion: May 15, 2025
• Last Updated: March 19, 2026

Record last verified: 2026-03

Data Sharing

• IPD Sharing: Will not share

Locations

CH (1)