Stapling Versus Hand Suture for Gastroenteric Anastomosis in Roux-en-Y Gastric Bypass: a Randomized Clinical Trial

Abellán, Israel; López, Víctor; Luján, Juan; Abrisqueta, Jesús; Hernández, Quiteria; Frutos, María Dolores; Parrilla, Pascual

doi:10.1007/s11695-015-1638-2

Cited by 29 publications

(5 citation statements)

References 21 publications

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“…The available short-term weight loss results for up to 2 years suggest similar results with each technique; however, most of these studies are comparing just two techniques [16,17]. There are even fewer studies investigating the three techniques simultaneously, with those suggesting no difference between them on the short term [18].There are no studies investigating weight loss in relation to all three gastrojejunostomy technique beyond 2 years.…”

Section: Purposementioning

confidence: 99%

Gastrojejunal Anastomotic Technique. Does It Matter? Weight Loss and Weight Regain 5 Years After Laparoscopic Roux-en-Y Gastric Bypass

et al. 2020

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Purpose The gastrojejunostomy during laparoscopic Roux-en-Y gastric bypass (LRYGB) can be constructed by hand sewn (HSA), linear (LSA) and circular (CSA) stapler technique. They are all considered safe; however, it is not known which the best technique is. Short-term follow-up suggest no difference in weight loss or weight regain between them. However, there is no information on these parameters in the long term. Theatre time and cost are other important factors defining the best way to form gastrojejunostomy. Materials and Methods In a prospective longitudinal cohort study consecutive patients following primary LRYGB were recruited to a bariatric database in a tertiary care centre. Anastomotic technique, diameter, the length of operations and associated costs, weight loss and weight regain were recorded. Patients were followed up for 5 years. Results A total of 385 patients with an initial body mass index of 47.1 kg/m 2 (35-68) were enrolled to this study. This decreased to 33.3 kg/m 2 (21-54 kg/m 2) after 5 years. There was no difference in %TWL after 3 years, P = 0.296, or 5 years, P = 0.187, between the techniques. The number of patients with weight regain was not different after 3 years, P = 0.224, or 5 years, P = 0.795. All techniques had similar operative time. CSA has a higher material cost. Early anastomotic stricture was more common following HSA; however, the difference was not significant. Conclusion Mid-term weight loss and weight regain are not related to anastomotic technique, and there is no difference in operative time associated to them. Circular stapler technique has a higher material cost due to the additional stapler.

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Section: Purposementioning

confidence: 99%

Gastrojejunal Anastomotic Technique. Does It Matter? Weight Loss and Weight Regain 5 Years After Laparoscopic Roux-en-Y Gastric Bypass

et al. 2020

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“…No difference was found with regard to leak rates. The hand-sewn anastomosis compared to the circular stapler anastomosis results in lower wound infection rates and lower gastrointestinal bleeding rates, within the same operative time and comparable safety [32]. Whether these statements are also valid for RRYGB remains to be shown.…”

Section: Discussionmentioning

confidence: 97%

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

et al. 2020

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Background Proximal Roux-en-Y gastric bypass is commonly used to manage obesity, performed using laparoscopic or robotassisted minimally invasive surgery. As the prevalence of robotic bariatric surgery increases, further data is required to justify its use. Methods This was a large, retrospective analysis of prospectively recorded data for Roux-en-Y gastric bypass (RYGB) procedures performed using laparoscopic (LRYGB) or robotic (RRYGB; da Vinci Xi system, Intuitive Surgical Sàrl) surgery between January 2016 and March 2019. The surgical techniques did not differ apart from different trocar placements. Data collected included patient characteristics before and after RYGB, operative outcomes and complications. Results In total, 114 RRYGB and 108 LRYGB primary surgeries were performed. There were no significant differences between the groups, apart from a significantly shorter duration of surgery (116.9 vs. 128.9 min, respectively), lower C-reactive protein values at days 1 (31.1 vs. 44.1 mg/l) and 2 (50.3 vs. 77.8 mg/l) after the intervention, and overall complication rate (4.4 vs. 12.0%, Clavien-Dindo classification II-V) with RRYGB compared with LRYGB. There was a lower hemoglobin value in the postoperative course after RRYGB (12.1 vs. 12.6 g/dl, day 2). Conclusions In our experience, robotic RYGB has proven to be safe and efficient, with a shorter duration of surgery and lower rate of complications than laparoscopic RYGB. RRYGB is easier to learn and seems safer in less experienced centers. Increasing experience with the robotic system can reduce the duration of surgery over time. Further studies with higher evidence level are necessary to confirm our results.

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“…Este estudo reforça a ideia de que o OAGB pode ser uma opção preferencial para certos pacientes, dependendo de fatores individuais, incluindo objetivos de perda de peso, histórico médico e preferências pessoais. Finalmente, Abellán et al (2015) compararam o grampeamento versus sutura manual para anastomose gastroentérica em bypass gástrico Roux-en-Y, fornecendo insights valiosos sobre as técnicas de anastomose dentro do contexto específico do RYGB. Este estudo sugere que, embora ambas as técnicas sejam eficazes, a escolha entre grampeamento e sutura manual pode depender de considerações operacionais e da experiência do cirurgião.…”

Section: Comparação De Técnicas De Anastomose Em Bypass Gástricounclassified

Desenvolvimentos Recentes em Técnicas de Anastomose para Cirurgia Gastrointestinal: Uma Revisão

Pereira,

Bessa,

Egüez

et al. 2024

Braz. J. Implantol. Health Sci.

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Este artigo apresenta uma revisão abrangente dos desenvolvimentos recentes em técnicas de anastomose para cirurgia gastrointestinal, destacando inovações que prometem transformar a prática cirúrgica e melhorar os desfechos para os pacientes. Através de uma estratégia de busca meticulosa em bases de dados científicas, foram identificados estudos relevantes que exploram técnicas convencionais e emergentes, incluindo anastomose por compressão magnética, aplicação de suturas em camada seromuscular e anastomose guiada por ultrassonografia endoscópica (EUS). Os resultados indicam que tais inovações oferecem vantagens significativas, como redução de complicações pós-operatórias e melhoria na recuperação dos pacientes. A discussão enfatiza a importância da educação contínua e do desenvolvimento profissional, bem como a necessidade de ensaios clínicos randomizados para validar os benefícios dessas técnicas. A conclusão reitera o potencial dessas inovações para melhorar a qualidade de vida dos pacientes, destacando a necessidade de abordagens baseadas em evidências na adoção de novas tecnologias cirúrgicas. Esta revisão evidencia a evolução dinâmica das técnicas de anastomose e a importância de pesquisa e prática clínica informadas para avançar na cirurgia gastrointestinal.

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Stapling Versus Hand Suture for Gastroenteric Anastomosis in Roux-en-Y Gastric Bypass: a Randomized Clinical Trial

Abstract: HSA and CSA were techniques with similar safety and effectiveness in our study. HSA had a lower rate of bleeding complications and surgical wound infection, although it does require greater experience in laparoscopic hand suturing.

Cited by 29 publications

References 21 publications

Gastrojejunal Anastomotic Technique. Does It Matter? Weight Loss and Weight Regain 5 Years After Laparoscopic Roux-en-Y Gastric Bypass

Gastrojejunal Anastomotic Technique. Does It Matter? Weight Loss and Weight Regain 5 Years After Laparoscopic Roux-en-Y Gastric Bypass

The Impact of Robotics in Learning Roux-en-Y Gastric Bypass: a Retrospective Analysis of 214 Laparoscopic and Robotic Procedures

Desenvolvimentos Recentes em Técnicas de Anastomose para Cirurgia Gastrointestinal: Uma Revisão

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