Comparison of Stapled and Hand-Sewn Sleeve Gastrectomy

Abstract

Background: Sleeve gastrectomy is a stapler dependent bariatric procedure. A hand-sewn sleeve gastrectomy can be necessary under certain circumstances. Here, we aimed to compare the outcomes of hand-sewn and stapled sleeve gastrectomies for the first time.Materials and Methods: In the hand-sewn group, no staplers were used and after vertical resection of the stomach by energy devices, the remnant stomach was closed by two rows intracorporeal sutures. In the stapler group, sleeve gastrectomy was done in the usual way.Results: Total of 13 patients were compared (hand-sewn:6 and stapled:7). All the sleeve gastrectomies completed laparoscopically. The operating time was longer 200 (100-300) minutes vs. 135 (60-220) minutes, p:0.07) and amount of bleeding was higher 105 (50-190) vs. 35 (10-45) ml., p:0.004) in the hand-sewn group. Leakage and gastrointestinal bleeding were seen in the hand-sewn group but no complications were found in the stapler group. No statistically significant difference was found between metabolic outcomes of the two groups three years after the operation (p>0.05). Excess of body mass index loss (EBMIL) of hand-sewn group and stapler group following three years (52.9% and 60%, respectively) were similar.Conclusion: Laparoscopic hand-sewn sleeve gastrectomy can be an alternative procedure to stapled sleeve gastrectomy in certain circumstances. Longer procedure time and more blood loss were associated with hand-sewn sleeve gastrectomy.