The methylene blue dye leak test is considered established practice in laparoscopic Roux-en-Y gastric bypass. 1,2 Laparoscopic sleeve gastrectomy is rising in popularity. Dye is delivered via an orogastric tube, with an instrument placed across the gastrectomy sleeve, preventing passage to the pylorus. Most standard laparoscopic instruments cannot compress the sleeve adequately. We use the partially closed endoscopic linear stapler, with the discarded cartridge, previously used in the longitudinal gastrectomy. At 60 mm, it gives good compression across the length to occlude the stomach beyond the inferior end of the staple line. It is safe, effective, readily available and adds no further cost.

Laparoscopic Nissen fundoplication involves retraction of the gastro-oesophageal junction using a Penrose drain to create a retro-oesophageal window. 1 We describe a latex-free alternative to the Penrose drain for patients with latex allergy. A size 8 or larger latex-free glove is fashioned into a sling, by cutting away all but the index and middle-finger portions (Fig 1). The bridge between these fingers, which normally covers the surgeon's interdigital space, forms the sling apex. This is passed around the distal oesophagus exactly as a Penrose drain and offers a safe, quick, and cost-effective latex-free alternative (Fig 2).