A cholangiogram catheter with a 3-0 prolene suture tied in a loop proximal to the balloon is introduced into the small gastrotomy. The balloon is inflated after insertion.
The left lateral trochar is removed and the 21mm endoscopic circular stapler anvil is introduced into the abdomen. A 6cm loop of 2-0 silk is tied through the tip of the anvil stem prior to introduction. The anvil loop is passed through the catheter loop and then slipped around the anvil to lock the two together.
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