Seamguard Buttressing of the Staple Line During Laparoscopic Sleeve Gastrectomy Appears to Decrease the Incidence of Postoperative Bleeding, Leaks, and Reoperations. A Systematic Review and Meta-Analysis of Non-Randomized Comparative Studies

Abstract

Leaks and bleeding are major acute postoperative complications following laparoscopic sleeve gastrectomy (LSG). Various staple line reinforcement (SLR) methods have been invented such as oversewing, omentopexy/gastropexy, gluing, and buttressing. However, many surgeons don't use any type of reinforcement. On the other hand, surgeons who use a reinforcement method are often confused of what kind of reinforcement they should use. No robust and high-quality data supports the use of one reinforcement over the other, or even supports the use of reinforcement over no reinforcement. Therefore, SLR is a controversial topic that is worth our focus. The aim of this study is to compare the outcomes of LSG with versus without Seamguard buttressing of the staple line during LSG. Key PointsSeamguard buttressing decreases the incidence of postoperative bleeding.Seamguard buttressing decreases the incidence of postoperative leaks.Seamguard buttressing decreases the incidence of re-operations.No heterogeneity among studies was observed, a conclusion reached after calculating prediction intervals and I 2 .

Staple Line Reinforcement during Sleeve Gastrectomy with SeamGuard: Single-Center Retrospective Case-Control Study over a 5-Year Period

“…In contrast, a recent meta-analysis demonstrated that only oversewing was an effective method to reduce bleeding and SLC after LSG [ 24 ]. Recent studies have confirmed that both SeamGuard and oversewing could reduce SLC after LSG [ 25 , 26 , 27 ]. Although the use of APM has reduced in recent years [ 28 ], in our institutions, we have continued to use GoR as the only SLR in the period of this study.…”