Outcomes of linear-stapled versus hand-sewn gastrojejunal anastomosis in laparoscopic Roux en-Y gastric bypass

Awad, Sherif; Aguilo, Rachel; Agrawal, Sanjay; Javed, Ali

doi:10.1007/s00464-014-3942-7

Cited by 28 publications

(15 citation statements)

References 18 publications

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“…Despite being mechanical anastomoses technically easier and operatively faster, recent studies have described a lower rate of wound infection and postoperative bleeding in case of hand-sewn anastomoses, with a leak rate comparable to the mechanical ones 2,14,15 . In our series, the overall complications rate was 4.5%, close to that reported in the literature, without difference between 2D and 3D groups 2,16 .…”

Section: ■ Discussionsupporting

confidence: 90%

“…We measured a 203 ± 51 minutes long OT for 2D LRYGB with hand-sewn anastomoses, similar to the one reported by Acín-Gándara et al 2 , but longer to the ones described by Finks et al 29 and Awad et al 16 (127.1 ± 50.4 and 127 ± 30 minutes respectively). To test the reliability of our findings and to eliminate confounders, multivariate analyses were carried out.…”

Section: ■ Discussionsupporting

confidence: 87%

“… 29 and Awad et al . 16 (127.1 ± 50.4 and 127 ± 30 minutes respectively). To test the reliability of our findings and to eliminate confounders, multivariate analyses were carried out.…”

Section: Discussionmentioning

confidence: 97%

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Three-dimensional laparoscopic Roux-en-Y gastric bypass with totally hand-sewn anastomoses for morbid obesity. A single center experience

et al. 2020

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To assess the impact of three-dimensional (3D) vision use on operative time (OT) in laparoscopic Roux-en-Y gastric bypass (LRYGB) with hand-sewn anastomoses. Methods: We analyzed a prospectively collected database of patients who underwent LRYGB. We included all patients operated on with either 2D or 3D vision. Demographics and clinical characteristics, operative time, hospital stay and 30-day postoperative complications were collected for all patients and analyzed. Results: During the study time, out of 143 patients who underwent LRYGB for morbid obesity, 111 were considered eligible. Seventy-eight patients were operated with 2D vision and 33 patients with 3D vision. Demographics and clinical characteristics were not different among groups. Mean OT was 203±51 and 167±32 minutes in the 2D and 3D groups respectively (p<0.001). Multivariate analyses showed that increasing age and BMI were independently related to prolonged OT, while 3D vision (OR 6.675, 95% CI 2.380-24.752, p<0.001) was strongly associated with shorter OT. Conclusions: The use of 3D vision in LRYGB significantly reduced the OT, though intra-and postoperative complication rates and the length of hospital stay were not affected. Despite its limitations, our study supports the value of 3D vision laparoscopy in bariatric surgery.

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Section: ■ Discussionsupporting

confidence: 90%

Section: ■ Discussionsupporting

confidence: 87%

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Three-dimensional laparoscopic Roux-en-Y gastric bypass with totally hand-sewn anastomoses for morbid obesity. A single center experience

et al. 2020

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“…Initial studies were inconclusive. Some are suggesting that HSA has a higher stenosis rate [ 20 ], whereas others showed lower rates [ 21 ]. Some these studies employed three different procedures early in the learning curve, which may have confounded the results.…”

Section: Resultsmentioning

confidence: 99%

“…Some these studies employed three different procedures early in the learning curve, which may have confounded the results. More recent evidence has demonstrated no increased risk from hand-sewn versus linear-stapled anastomosis with regards to leaks, bleeding, or stenosis [ 20 , 22 ]. Extrapolating from this, the evidence seems to suggest that hand-sewn gastric closure would be safe, though studies comparing this with LSA directly will be required.…”

Section: Resultsmentioning

confidence: 99%

Stapleless Laparoscopic Sleeve Gastrectomy: Reasoning and Technical Insights

2017

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BackgroundLaparoscopic sleeve gastrectomy (LSG) with staple line reinforcement (SLR) is a popular and safe treatment option for morbid obesity. We have developed, devised, and described our own method of stapleless laparoscopic sleeve gastrectomy, which in our limited study appeared safe, efficacious, and potentially cost-effective.MethodsWe analyzed the outcome of our modified LSG in a case series of three middle-aged women (median age 42 years old). Our main modification was sutured closure of the stomach rather than the commonly utilized technique of stapled closure. Our primary measure of success was the occurrence of post-operative leak. Secondary measures were (a) length of operation, (b) duration of inpatient stay, and (c) percentage of weight loss at 6 and 12 months post operation.ResultsMedian operative time = 132 min (120–195 min), and median inpatient stays were 2 days. No post-operative leaks were recorded. The median excess weight loss at 6 months was 39% of initial weight loss and 57.7% at 12 months.ConclusionsStapleless LSG has the potential to be an affordable alternative to the traditional LSG. High-powered studies and a formal cost analysis are required.

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Preventing Complications

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Cuéllar

et al. 2020

Gastric Bypass

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Outcomes of linear-stapled versus hand-sewn gastrojejunal anastomosis in laparoscopic Roux en-Y gastric bypass

Abstract: When performed by 'technique-specific' surgeons, both LS and HS GJA in LRYGB may be performed safely with no significant differences in morbidity, reoperations, or EWL.

Cited by 28 publications

References 18 publications

Three-dimensional laparoscopic Roux-en-Y gastric bypass with totally hand-sewn anastomoses for morbid obesity. A single center experience

Three-dimensional laparoscopic Roux-en-Y gastric bypass with totally hand-sewn anastomoses for morbid obesity. A single center experience

Stapleless Laparoscopic Sleeve Gastrectomy: Reasoning and Technical Insights

Preventing Complications

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