Laparoscopic Sleeve Gastrectomy versus Laparoscopic Banded Sleeve Gastrectomy: First Prospective Pilot Randomized Study

Introduction. The placement of ring or band around the gastric tube might prevent the dilation after Laparoscopic Sleeve Gastrectomy (LSG). We describe the first randomized study comparing LSG and Laparoscopic Banded Sleeve Gastrectomy (LBSG).Material and Method. Fifty obese patients were enrolled in the study between January 2014 and January 2015. We analysed differences in operative time, complication rate, mortality, and BMI between the two groups over a period of 12 months.Results. Twenty-five patients received LSG (group A) and 25 LBSG (group B). The mean preoperative BMI was47.3±6.58 kg/m2and44.95±5.85 kg/m2, respectively, in the two groups. There was no statistical relevant difference in operative time. No intraoperative complications occurred. Mean BMI registered after 3, 6, and 12 months in groups A and B, respectively, were37.86±5.72 kg/m2and37.58±6.21 kg/m2(p=0.869),33.64±6.08 kg/m2and32.03±5.24 kg/m2(p=0.325), and29.72±4.40 kg/m2and27.42±4.47 kg/m2(p=0.186); no statistical relevant difference was registered between the two groups.Conclusion. LBSG is a safe and feasible procedure. The time required for the device positioning did not influence significantly the surgical time. The results of bodyweight loss did not document any statistically significant differences among the two groups, even though LBSG group showed a mean BMI slightly lower than that of the control group.

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Omentopexy with Glubran®2 for reducing complications after laparoscopic sleeve gastrectomy: results of a randomized controlled study

BMC Surgery ◽

10.1186/s12893-019-0507-7 ◽

2019 ◽

Vol 19 (S1) ◽

Cited By ~ 1

Author(s):

Vincenzo Pilone ◽

Salvatore Tramontano ◽

Michele Renzulli ◽

Mafalda Romano ◽

Angela Monda ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Operative Time ◽

Controlled Study ◽

Control Group ◽

Group A ◽

Group B ◽

High Level

Abstract Background Gastric fistulas, bleeding, and strictures are commonly reported after laparoscopic sleeve gastrectomy (LSG), that increase morbidity and hospital stay and may put the patient’s life at risk. We report our prospective evaluation of application of synthetic sealant, a modified cyanoacrylate (Glubran®2), on suture rime, associated with omentopexy, to identify results on LSG-related complications. Methods Patients were enrolled for LSG by two Bariatric Centers, with high-level activity volume. Intraoperative recorded parameters were: operative time, estimated intraoperative bleeding, conversion rate. We prospectively evaluated the presence of early complications after LSG during the follow up period. Overall complications were analyzed. Perioperative data and weight loss were also evaluated. A control group was identified for the study. Results Group A (treated with omentopexy with Glubran®2) included 96 cases. Control group included 90 consecutive patients. There were no differences among group in terms of age, sex and Body Mass Index (BMI). No patient was lost to follow-up for both groups. Overall complication rate was significantly reduced in Group A. Mean operative time and estimated bleeding did not differ from control group. We observed three postoperative leaks in Group B, while no case in Group A (not statistical significancy). We did not observe any mortality, neither reoperation. Weight loss of the cohort was similar among groups. In our series, no leaks occurred applying omentopexy with Glubran®2. Conclusion Our experience of omentopexy with a modified cyanoacrylate sealant may lead to a standardized and reproducible approach that can be safeguard for long LSG-suture rime. Trial registration Retrospective registration on clinicaltrials.gov PRS, with TRN NCT03833232 (14/02/2019).

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Role of staple line fixation during laparoscopic sleeve gastrectomy

International Surgery Journal ◽

10.18203/2349-2902.isj20175887 ◽

2017 ◽

Vol 5 (1) ◽

pp. 156 ◽

Cited By ~ 2

Author(s):

Mohammed A. Elbalshy ◽

Asem M. Fayed ◽

Moharm A. Abdelshahid ◽

Yahia M. Alkhateep

Keyword(s):

Sleeve Gastrectomy ◽

Gastric Emptying ◽

Laparoscopic Sleeve Gastrectomy ◽

Operative Time ◽

Staple Line ◽

Simple Procedure ◽

Randomized Study ◽

Axial Rotation ◽

Minimal Effect ◽

Group A

Background: Although sleeve gastrectomy provides a technically simple procedure with minimal effect on digestive tract it deprives the stomach of its ligaments of fixation which results in impairment of gastric functions, vomiting, axial gastric rotation in addition to bleeding or leakage from the stable line. Objective of present study is the effect of stable line fixation during sleeve gastrectomy.Methods: This is a prospective randomized study using closed envelop method carried on 100 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy (LSG) they were divided into two groups each is 50 patient group A underwent classic (LSG) with no fixation and group (B) with staple line fixation.Results: Patients were 68 females and 32 males with a mean age of 32.2±5.7 years, mean (BMI) 48.9±8.6kg/m2. postoperative vomiting, gastric axial rotation, impaired gastric emptying all were significantly higher in group A. Although both staple line bleeding and leakage were higher in the group A, but it was not statistically significant. Also, the operative time was shorter in the group A, but it was not significant.Conclusions: staple line fixation should be a step during sleeve gastrectomy as it regains the stomach its ligaments of fixation anatomically and so functions better less vomiting, less gastric axial rotation, better gastric emptying in addition to decreasing staple line bleeding and leakage with minimal effect on operative time.

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A prospective randomized study on staple line reinforcement during laparoscopic sleeve gastrectomy: fibrin glue, Ifabond or none?

Chirurgia ◽

10.23736/s0394-9508.18.04786-1 ◽

2018 ◽

Vol 31 (6) ◽

Author(s):

Sinan Binboga ◽

Hakan Seyit ◽

Elif Binboga ◽

Pinar Kasapoglu ◽

Osman Kones ◽

...

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Fibrin Glue ◽

Staple Line ◽

Randomized Study ◽

Prospective Randomized Study ◽

Staple Line Reinforcement

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Banded Sleeve Gastrectomy Improves Weight Loss Compared to Nonbanded Sleeve: Midterm Results from a Prospective Randomized Study

Journal of Obesity ◽

10.1155/2020/9792518 ◽

2020 ◽

Vol 2020 ◽

pp. 1-7 ◽

Cited By ~ 2

Author(s):

Paolo Gentileschi ◽

Emanuela Bianciardi ◽

Leandro Siragusa ◽

Valeria Tognoni ◽

Domenico Benavoli ◽

...

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Weight Regain ◽

Randomized Study ◽

Banded Sleeve Gastrectomy ◽

Group A ◽

The Mean ◽

Group B ◽

To Receive

Background. Weight regain after laparoscopic sleeve gastrectomy (LSG) is nowadays a growing concern. Sleeve dilatation and loss of food restriction is considered the main mechanism. The placement of a silicon ring around the gastric tube seems to give benefits in the short term. We report the results of a randomized study comparing LSG and laparoscopic banded sleeve gastrectomy (LBSG) over a 4-year follow-up. Objectives. To evaluate the efficacy of banded sleeve gastrectomy compared to standard sleeve in the midterm. Methods. Between 01/2014 and 01/2015, we randomly assigned 50 patients to receive one of the two procedures. Patients’ management was exactly the same, apart from the band placement. We analyzed differences in weight loss, operative time, complication rate, and mortality, with a median follow-up of 4 years. Results. Twenty five patients were assigned to receive LSG (Group A) and 25 LBSG (Group B). The mean preoperative BMI (body mass index) was 47.3 ± 6.58 kg/m2 and 45.95 ± 5.85 kg/m2, respectively. There was no significant difference in the operative time. No intraoperative or postoperative complications occurred. At 12-month follow-up, the mean BMI was 29.72 ± 4.40 kg/m2 in Group A and 27.42 ± 4.47 kg/m2 in Group B (p=0.186). After a median follow-up of 4 years, the mean BMI in Group B was significantly lower than Group A (24.10 ± 4.52 kg/m2 vs 28.80 ± 4.62 kg/m2; p=0.00199). Conclusions. LBSG is a safe procedure, with no impact on postoperative complications. The banded sleeve showed a significant greater weight loss in the midterm follow-up. Considering the issue of weight regain observed after LSG, the placement of a perigastric ring during the first procedure may be a strategy to improve the results. This trial is registered with NCT04228185.

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Staple line oversewing during laparoscopic sleeve gastrectomy

Annals of The Royal College of Surgeons of England ◽

10.1308/rcsann.2017.0074 ◽

2017 ◽

Vol 99 (7) ◽

pp. 509-514 ◽

Cited By ~ 9

Author(s):

H Wang ◽

J Lu ◽

J Feng ◽

Z Wang

Keyword(s):

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Operative Time ◽

Web Of Science ◽

Staple Line ◽

Weighted Mean Difference ◽

Meta Analysis ◽

Significant Difference ◽

Comprehensive Search ◽

Randomised Controlled

Introduction This meta-analysis was performed to assess the possible benefits of staple line oversewing during laparoscopic sleeve gastrectomy. Methods A comprehensive search up to February 2017 was conducted on PubMed, the Web of Science™ and Embase™. All eligible studies were included, and the outcomes of staple line bleeding and leak, overall complications and operative time were pooled. Results A total of 7 randomised controlled trials involving 845 patients (428 cases and 417 controls) were analysed. There was no significant difference in staple line bleeding (relative risk [RR]: 0.858, 95% confidence interval [CI]: 0.343–2.143, p=0.742), leak (RR: 0.650, 95% CI: 0.257–1.644, p=0.363) or overall complications (RR: 0.913, 95% CI: 0.621–1.342, p=0.644) between the oversewing group and the patients who did not have oversewing. Oversewing of the staple line was associated with a longer operative time (weighted mean difference: 14.400, 95% CI: 7.198–21.602, p=0.000). Conclusions Oversewing the staple line during laparoscopic sleeve gastrectomy does not decrease the risk of staple line bleeding, leakage or overall complications but it does prolong the operative time.

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Scintigraphic evaluation of gastric emptying after greater curvature plication in comparison with sleeve gastrectomy

Iranian Journal of Nuclear Medicine ◽

10.18502/irjnm.v27i1.971 ◽

2019 ◽

Author(s):

Tarek Osama Hegazy ◽

Ahmed Kandeel ◽

Mohamed el shawadfy ◽

Khalid Kassem ◽

Mohamed Hassan

Keyword(s):

Weight Loss ◽

Sleeve Gastrectomy ◽

Gastric Emptying ◽

Hospital Stay ◽

Laparoscopic Sleeve Gastrectomy ◽

Operative Time ◽

Gastric Plication ◽

Term Outcome ◽

Body Mass Index Loss ◽

The Mean

Introduction: Laparoscopic gastric plication (LGP) is a relatively new restrictive bariatric procedure that emerged to avoid the problems and to reduce the cost of laparoscopic sleeve gastrectomy. In this study we present the initial short-term outcome of LGP and its effect on gastric emptying and compare it with the results of laparoscopic sleeve gastrectomy (LSG). Methods: From May 2016 to April 2017, a total of 50 patients were allocated to undergo either LGP (n = 25) or LSG (n = 25). Data on the operative time, complications, hospital stay, overall cost of LSG and LGCP, body mass index loss (BMIL), post-operative gastric emptying (the first study to asses gastric emptying after LGP), percentage of excess weight loss (%EWL), and improvement of comorbidities were collected during the follow-up examinations. Results: All procedures were completed laparoscopically. The mean operative time was significantly higher for the LGP group. The mean hospital stay, cost and %EWL were significantly higher in the LSG group. The mean gastric emptying t1/2 was 40 ± 13 minutes for LGP group and 28.3 ± 8.31 minutes for LSG group (P = 0.001). Conclusion: There is significant acceleration of gastric emptying after LSG more than after LGP with significant effect on weight loss.

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Laparoscopic Sleeve Gastrectomy for Mildly Obese Patients (Body Mass Index of 30 <35 kg/m2): Operative Outcome and Short-Term Results

Journal of Obesity ◽

10.1155/2012/813650 ◽

2012 ◽

Vol 2012 ◽

pp. 1-5 ◽

Cited By ~ 10

Author(s):

Roger Noun ◽

Ghassan Chakhtoura ◽

Marwan Nasr ◽

Judith Skaff ◽

Naîm Choucair ◽

...

Keyword(s):

Body Mass Index ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Body Mass ◽

Operative Time ◽

Excess Weight ◽

Obese Patients ◽

Short Term ◽

Preoperative Body Mass Index ◽

Mild Obesity

Background. Data concerning laparoscopic sleeve gastrectomy (LSG) in mild obesity are under investigation.Aim/Objective. May 2010 to May 2012, 122 consecutive patients with preoperative body mass index (BMI) of33±2.5 kg/m2(range 30–34.9) undergoing LSG were studied. Mean age was33±10years (range 15–60), and 105 (86%) were women. Mean preoperative weight was91±9.7 kg (range 66–121), and preoperative excess weight was30±6.7 kg (range 19–43). Comorbidities were detected in 44 (36%) patients.Results. Mean operative time was58±15 min (range 40–95), and postoperative stay was1.8±0.19days (range 1.5–3). There were no admissions to intensive care unit and no deaths within 30 days of surgery. The rates of leaks and strictures were 0%, and of hemorrhage 1.6%. At 12 months, BMI decreased to24.7±2, and the percentage of excess weight loss (% EWL) reached 76.5%. None of the patients had a BMI below 20 kg/m2. Comorbidities resolved in 70.5% or improved in 29.5%. Patient satisfaction scoring (1–5) at least 1 year after was4.6±0.8for body image and4.4±0.6for food tolerance.Conclusion. LSG for mildly obese patients has proved to be technically relatively easy, safe, and benefic in the short term.

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Weight Loss after Sleeve Gastrectomy in Super Superobesity

Journal of Obesity ◽

10.1155/2012/959260 ◽

2012 ◽

Vol 2012 ◽

pp. 1-4 ◽

Cited By ~ 10

Author(s):

J.-M. Catheline ◽

M. Fysekidis ◽

R. Dbouk ◽

A. Boschetto ◽

H. Bihan ◽

...

Keyword(s):

Weight Loss ◽

Gastric Bypass ◽

Sleeve Gastrectomy ◽

Laparoscopic Sleeve Gastrectomy ◽

Operative Time ◽

Postoperative Mortality ◽

Gastric Fistula ◽

Second Stage ◽

The Mean ◽

Complete Situs Inversus

Objective. This prospective study evaluated laparoscopic sleeve gastrectomy for its safety and efficiency in excess weight loss (%EWL) in super superobese patients (BMI>60 Kg/m2).Results. Thirty patients (33 women and 7 men) were included, with mean age of 35 years (range 18 to 59). Mean preoperative BMI was 66 Kg/m2(range 60 to 85). The study included one patient with complete situs inversus and 4 (14%) with previous restrictive gastric banding. The mean operative time was 120 minutes (range 80 to 220 min) and the mean hospital stay was 7.5 days (4 to 28 days). There was no postoperative mortality or need for a laparotomy conversion. Two subphrenic hematomas, one gastric fistula, and one pulmonary embolism, were the major complications. After 18 months 17 (77%) had sufficient weight loss and six had insufficient results, leading to either re-sleeve gastrectomy (3), or gastric bypass (2). Three years after the initial laparoscopic sleeve gastrectomy, the mean EWL was 51% (range 21 to 82).Conclusion. The laparoscopic sleeve gastrectomy is a safe and efficient operating procedure for treating super superobesity. In the case of insufficient weight loss, a second-stage operation like resleeve gastrectomy or gastric bypass can be proposed.

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