Stapleless Laparoscopic Sleeve Gastrectomy: a Relatively New Approach in Bariatric Surgery

Vinayak, C. Rajkumar; Lechmiannandan, Sivaneswaran; Ramasamy, Umasangar

doi:10.1007/s11695-016-2376-9

Cited by 1 publication

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“…However, a recent comment on stapleless laparoscopic Roux-en-Y gastric bypass (LRYGBP), exemplifies some of the hypothetical critiques of stapleless LSG, stating that “ the potential advantage of avoiding leaks and fistulas may not be consistent overall ,” describing it as “ cumbersome and time-consuming ,” and finally that “ the reductions in cost may not be worth it if complication rates increase ” [ 9 ]. Given the dearth of literature looking specifically at stapleless LSG [ 10 , 11 ], we will look at LSG with oversewing as a proxy. We will place the hypothetical critiques in the context of the broader literature and address them one by one.…”

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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Section: Resultsmentioning

confidence: 99%