scholarly journals Role of staple line fixation during laparoscopic sleeve gastrectomy

2017 ◽  
Vol 5 (1) ◽  
pp. 156 ◽  
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.

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

2016 ◽  
Vol 2016 ◽  
pp. 1-5 ◽  
Author(s):  
Valeria Tognoni ◽  
Domenico Benavoli ◽  
Emanuela Bianciardi ◽  
Federico Perrone ◽  
Simona Ippoliti ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Operative Time ◽  
Intraoperative Complications ◽  
Randomized Study ◽  
Control Group ◽  
Bodyweight Loss ◽  
Relevant Difference ◽  
Banded Sleeve Gastrectomy ◽  
Time Required

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.

scholarly journals Staple line oversewing during laparoscopic sleeve gastrectomy

2017 ◽  
Vol 99 (7) ◽  
pp. 509-514 ◽  
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.

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

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.

scholarly journals Staple line reinforcement during laparoscopic sleeve gastrectomy: pros and cons

2019 ◽  
Vol 6 (8) ◽  
pp. 2677
Author(s):  
Samir A. Abdelmageed ◽  
Mena Z. Helmy
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Staple Line ◽  
Randomized Study ◽  
Length Of Hospital Stay ◽  
University Hospital ◽  
Staple Line Reinforcement ◽  
Group I ◽  
Suture Group ◽  
Group Ii

Background: Nowadays, laparoscopic sleeve gastrectomy (LSG) is the most common performed bariatric procedure. Staple line reinforcement (SLR) advised for reducing gastric leaks and bleeding after LSG. The aim of this study is to evaluate the efficacy of SLR in reducing the postoperative complications compared to non-SLR during LSG.Method: Sixty morbid obese patients were scheduled for LSG in this prospective randomized study at Sohag University Hospital in the period between March 2016 to February 2018. Patients were divided randomly into two groups: Group I included 30 patients underwent LSG with over sewing of the staple line with running suture using VLoc™ V 3/0 suture. Group II underwent LSG without SLR (n=30).Results: No cases with leaks or stenosis were detected in our series. The operative time was significantly longer in the SLR group compared to the non-SLR group (125 (110-160) vs 100 (90-125) minutes respectively, p<0.01). Staple line bleeding was detected postoperatively only in one case in group II (3.3%) which was treated conservatively. The length of hospital stay was longer in the non-reinforcement group but not significantly different (p=0.25).Conclusions: Staple line reinforcement during LSG has no superiority on the outcome of this operation, used by surgeons as a personal preference and as a security shield rather than for its advantages.  

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

BMC Surgery ◽  
2019 ◽  
Vol 19 (S1) ◽  
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).

scholarly journals Effects and Results of Omentopexy During Laparoscopic Sleeve Gastrectomy on Possible Post Operative Bleeding and/or Leakage

QJM ◽  
2020 ◽  
Vol 113 (Supplement_1) ◽  
Author(s):  
E S Saber ◽  
A M Ibrahim ◽  
F M Benjamine
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Operative Time ◽  
Mutual Effect ◽  
Suture Line ◽  
Full Thickness ◽  
Average Operative Time ◽  
Group A ◽  
Group B ◽  
Titanium Clips

Abstract Background In laparoscopic sleeve gastrectomy, patients may experience some post-operative complications as hemorrhage or leakage.We aim by this study to evaluate the benefit of omental fixation with full thickness stitches in decreasing post-operative hemorrhage and leakage, and the mutual effect on the patient and the surgeon. Methods A retrospective analysis of collected data including 200 laparoscopic sleeve gastrectomy (LSG) from September 2016 to September 2018, procedures were divided into two groups, group A of 100 LSG procedures without omental fixation but clipping the whole suture line with titanium clips if any bleeding point present, and group B 100procedures with omental fixation with full thickness stitches till the level of incisura above, and below with titanium clips to control bleeders if present. Results Of group A there were 9 cases of leakage needed intragastric stent and feeding jejunostomy (0.9%), 26 cases of bleeding (2.6%) 15 cases of them needed relaparoscopy and ful lthickness stitches (1.5%) and 11 cases of them managed conservatively with blood transfusion (1.1%), and 3 cases of perigastric localized collection managed by pigtail and antibiotics (0.3%), average operative time was 55 minutes (between 35-75 minutes).Of group B there were 8bleeding cases of drain with less than 300 cc were managed conservatively (0.8%), and 1 case of perigastric localized collection managed conservatively without pigtail (0.1%), No leakage was identified nor hematoma, average operative time 85 minutes (between 50 to 120 minutes). Conclusion The step of omental fixation with full thickness stitches has shown to be effective in decreasing staple line bleeding and leakage although it minimally prolongs the operative time of LSG.

scholarly journals Role of Rendezvous-Procedure in the Treatment of Complications after Laparoscopic Sleeve Gastrectomy

2021 ◽  
Vol 10 (23) ◽  
pp. 5670
Author(s):  
Dörte Wichmann ◽  
Veit Scheble ◽  
Stefano Fusco ◽  
Ulrich Schweizer ◽  
Felix Hönes ◽  
...  
Keyword(s):  
Sleeve Gastrectomy ◽  
Laparoscopic Sleeve Gastrectomy ◽  
Negative Pressure ◽  
Staple Line ◽  
Complication Rates ◽  
Negative Pressure Therapy ◽  
Pressure Therapy ◽  
Staple Line Leaks ◽  
Group A ◽  
Group B

Introduction: Laparoscopic sleeve gastrectomy is one of the most commonly performed bariatric procedures worldwide with good results, high patient acceptance, and low complication rates. The most relevant perioperative complication is the staple line leak. For the treatment of this complication, endoscopic negative pressure therapy has proven particularly effective. The correct time to start endoscopic negative pressure therapy has not been the subject of studies to date. Methods: Twelve patients were included in this retrospective data analysis over three years. Endoscopic negative pressure therapy was carried out using innovative open pore suction devices. Patients were treated with simultaneous surgery and endoscopy, so called rendezvous-procedure (Group A) or solely endoscopically, or in sequence surgically and endoscopically (Group B). Therapy data of the procedures and outcome measures, including duration of therapy, therapy success, and change of treatment strategy, were collected and analysed. Results: In each group, six patients were treated (mean age 52.96 years, 4 males, 8 females). Poor initial clinical situation, time span of endoscopic negative pressure therapy (Group A 31 days vs. Group B 18 days), and mean length of hospital stay (Group A 39.5 days vs. Group B 20.17 days) were higher in patients with rendezvous procedures. One patient in Group B died during the observation time. Discussion: Rendezvous procedures for patients with staple line leaks after sleeve gastrectomy is indicated for serious ill patients with perigastric abscesses and in need of laparoscopic lavage. The one-stage complication management with the rendezvous procedure seems not to result in an obvious advantage in the further outcome in patients with staple line leaks after laparoscopic sleeve gastrectomy.

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