Review of Our Experience Using Modified Staple Line Suturing Technique in Laparoscopic Sleeve Gastrectomy

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) has become the most common bariatric surgical method in recent years. Although LSG provides good outcomes, serious complications such as leakage, bleeding, and stenosis may develop postoperatively. Numerous staple line reinforcement methods have been used to reduce complications. Whether each one of these practices is effective remains controversial. Aim: Our study aims to assess outcomes and safety of modified (purse-string+oversewing) staple line suturing technique for patients who underwent LSG. Materials and Methods: A total of 505 patients who underwent LSG with modified staple line suturing technique between March 2018 and February 2021 were included in this retrospective study. Age, sex, body mass index, operation time, perioperative and postoperative 30-day complications were recorded in all patients. Results: Of 505 patients (59.6% female) with a mean age of 37.6 years (minimum to maximum: 12 to 68 y) and median body mass index of 40.2 kg/m2 (minimum to maximum: 32 to 75 kg/m2) underwent LSG. LSG was performed as revision surgery in 17 (3.4%) patients. Five (1%) patients also underwent concomitant cholecystectomy. The mean operation time was 92 minutes (75 to 110 min) in our primary LSG cases. Operative complications included minor hepatic injury in 8 (1.6%) and anesthesia awareness in 3 (0.6%) patients. Postoperative complications included bleeding which occurred in 2 (0.4%) patients, portomesenteric vein thrombosis in 1 (0.2%), and minor wound infection in 3 (0.6%) patients. There was no leak, no stenosis, and no mortality. Conclusion: Sleeve gastrectomy with modified staple line suturing technique is an effective method and could be safely applied with low morbidity.

Combined Partial Toupet Fundoplication With Laparoscopic Sleeve Gastrectomy for Patients With Morbid Obesity and Symptomatic GERD: Preliminary Results of the T-sleeve Technique

“…Our primary LSG technique has been previously described 11. All LSG operations were done by the same team and the same technique.…”

“…Our primary LSG technique has been previously described. 11 All LSG operations were done by the same team and the same technique. Using an optical trocar (12 mm Endopeth Xcel) for the first entry, with a 5-trocar technique, and sleeve gastrectomy over a 36 Fr bougie, starting 2 to 3 cm away from the pylorus was performed.…”

The Effect of Laparoscopic Sleeve Gastrectomy With Concomitant Hiatal Hernia Repair on Gastroesophageal Reflux Disease

“…Our surgical technique has been previously described 15. All LSG operations were done by the same team and the same technique.…”

“…Our surgical technique has been previously described. 15 All LSG operations were done by the same team and the same technique. Using an optical trocar for the first entry, with a 5-trocars technique, and sleeve gastrectomy over a 36 French bougie, starting 3 to 4 cm away from the pylorus was performed.…”