This the surgery of a 42 y old woman, BMI 48Kg/m2, associated Arterial hypertension, osteoartritis and reactive depression. Altough she had a small tpe I hiatal hernia we decided to perform a Single Anastomosis Gastric Bypass, with the Spanish technique + hiatal repair. As in several recent cases, ee were able not to use any special device as Liagsure or Ultracision. The operation took 65 minutes.
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