Continuing then in either an open or laparoscopic mode, the anvil is placed and the purse string secured. One may find that the completion of the following circular stapling technique may be possible through the exposure created in the base retractor. Frequently, however, it may be difficult to visualize the fashioning of anvil portion to the receiving pin of the circular stapler high in the epigastrium. In such case, the stapler can then be visualized and fashioned under pneumoperitoneal conditions. The device may be deployed in a makeshift fashion through a separate sleeve of the HandPort (note: on later models of HandPort there will be caps. These caps will contain variable sized valve mechanisms to allow insertion of instruments rather than a hand while still maintaining the laparoscopic environment). One should be aware that certain models of circular staplers are not airtight and will allow a variable amount of air leak. The remainder follows through the routine deployment of a circular stapler. The distal end of the Roux-en-Y limb is closed with a linear stapler.