Fig. 4.

Procedure for creating a delta-shaped anastomosis. a Small hole was created on the posterior side of the staple line of the proximal jejunum and on the mesenteric side of the staple line of the distal jejunum. b Dorsal walls of the proximal and distal walls of the jejunum were stapled with sufficient distance (arrows) between each other’s staple lines to maintain blood flow. c Common entry hole was temporarily closed by three full-thickness sutures while widening the V-shaped anastomosis made by first stapling and then permanently closed with a stapler. d Jejunojejunostomy was performed using delta-shaped anastomosis (double arrow: an appropriate gap between the staple lines of the proximal and distal jejunum stumps maintained the physiological axes of the intestinal tract). PJ proximal jejunum, DJ distal jejunum, VSA V-shaped anastomosis