A Practical Strategy of Controlled Monopolar Cautery With/Without Oversewing for Staple Line Bleeding in Bariatric Surgery: A Single Center Experience

Introduction In laparoscopic bariatric surgery, stapling devices are essential for creating a gastric tube or gastric pouch. Staple line bleeding (SLB) is an important issue, but the effect of monopolar cautery for SLB control is unclear. This study aimed to evaluate the outcomes of controlled monopolar cautery with/without oversewing for SLB control during bariatric surgery. Materials and Methods From January 2019 to May 2021, 66 patients underwent bariatric surgery with controlled monopolar cautery with/without oversewing for SLB control. Patient demographics and intraoperative and postoperative outcomes were analyzed. Results This study enrolled 35 women and 31 men (mean age: 38.1 years; mean body mass index: 39.8 kg/m2). All patients had varying degrees of SLB. Controlled monopolar cautery was applied to 63 patients with ≤6 bleeding sites. Only two patients needed further partial oversewing of the bleeding sites after controlled monopolar cautery failed to achieve hemostasis. Initially, three patients had more than six bleeding sites, and thus complete oversewing was performed to achieve successful hemostasis. There was no intraabdominal or gastrointestinal bleeding. There were one gastric stricture, one anastomotic leakage, and one staple line leakage. Conclusions The strategy of controlled monopolar cautery with/without oversewing is a simple, practical, inexpensive, and safe method for SLB control during bariatric surgery.