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Surgical procedure for Roux en Y reconstruction. (A) Division of the proximal jejunum. (B) Insertion of the 21 mm envil into the distal end of the divided jejunum and introduction of the body of a 21 mm stapler into 30 to 40 cm distal. (C) Insertion of another envil into the distal end of the resected jejunum. (D) Stapling for gastrojejunostomy.
