Surgical glue in laparoscopic sleeve gastrectomy: An initial experience and cost‐effectiveness analysis

Mercier, Grégoire; Loureiro, Marcelo de Paula; Georgescu, V.; Skalli, El Mehdi; Nedelcu, Marius; Ramadan, Mohamed; Fabré, J; Lefèbvre, Patrick; Nocca, David

doi:10.1111/jep.12685

Cited by 5 publications

(2 citation statements)

References 21 publications

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“…Bleeding control methods commonly aimed to control hemorrhage in the extra luminal origin staple line, clipping, fibrin sealant application or monopolar cautery like us. Mercier et al [5] compared effect of surgical glue with no staple line reinforcement method group and they find no differentiation on bleeding and leak rates. Coskun et al [1] reported that fibrin glue application on staple line, is an extraluminal bleeding control technique, zero leak and 0.3 % bleeding rate.…”

Section: Discussionmentioning

confidence: 99%

Staple Line Bleeding Control with Monopolar Cautery in Laparoscopic Sleeve Gastrectomy

Sağlam¹

2019

Laparosc Endosc Surg Sci

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Introduction: During a sleeve gastrectomy, cauterization of the staple line for bleeding control is not recommended due to the worry of weakening the staple line. This study is an evaluation of sleeve gastrectomy outcomes in a cohort where all staple line bleeding control was achieved using monopolar cautery. Materials and Methods:Between July 2014 and February 2019, monopolar cautery was used as the only method of staple line bleeding control following 187 sleeve gastrectomies. The rate of staple line leaks as well as intra-abdominal and intraluminal (gastrointestinal) bleeding was examined.Results: A total of 144 women and 43 men were enrolled in this study (mean age: 34.1 years; mean body mass index: 43.6 kg/m 2 ). There were 5 leaks from the staple line (2.6%) and 7 cases of gastrointestinal bleeding (3.7%). There was no instance of mortality. Conclusion:Staple line bleeding control with monopolar cautery during sleeve gastrectomy is a feasible, simple, inexpensive, and relatively safe method. Randomized trials are needed to compare monopolar cautery with other staple line bleeding control methods.

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Section: Discussionmentioning

confidence: 99%

Staple Line Bleeding Control with Monopolar Cautery in Laparoscopic Sleeve Gastrectomy

Sağlam¹

2019

Laparosc Endosc Surg Sci

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“…Use of glue to reinforce the staple line has not been shown to reduce postoperative hemorrhage. 39 The use of tranexamic acid as a routine intraoperative method of reducing hemorrhage has been proposed. 40 …”

Section: Discussionmentioning

confidence: 99%

Standardised Sleeve Gastrectomy Without Reinforcement

Lynn

Ilczyszyn

Aguilo

et al. 2018

JSLS

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Background and Objectives:Laparoscopic sleeve gastrectomy (LSG) has some unique complications, the most concerning of which is sleeve leak. Staple line reinforcement (SLR) has been suggested as a means of decreasing the risk of sleeve leak, but it increases the cost. However, there is little in the literature regarding the effect of standardized operative technique in reducing the complications and improving the outcomes in LSG. We sought to demonstrate that standardization of the operative procedure and perioperative care is the key to an excellent 30-day outcome and that SLR is not necessary to ensure a negligible staple line leak and bleeding rate.Methods:A prospectively maintained database was analyzed to identify 303 consecutive patients undergoing LSG between July 2010 and November 2017. Data on patient demographics, length of hospital stay, conversion to open surgery, perioperative complications, and mortality were analyzed. Standardized operative technique and postoperative protocol were followed in all cases. SLR was not used in any case.Results:Among 303 cases, there were 15 complications (5%), 5 (1.7%) of which were severe (Clavien-Dindo grade ≥3a). There were no conversions to open procedure, no staple line leaks, and no inpatient deaths in the cohort. No patient was readmitted with an early stricture.Conclusions:The use of a standardized operative and postoperative protocol led to an excellent early outcome in our LSG cases. Standardization may act to obviate the need for routine SLR techniques which are associated with a significant financial cost to both patient and hospital.

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Gastrectomie longitudinale

Nocca¹,

Silvestri²,

Alkhamis³

et al. 2019

Chirurgie Bariatrique

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Surgical glue in laparoscopic sleeve gastrectomy: An initial experience and cost‐effectiveness analysis

Abstract: Surgical glue might be a safe and cost-effective intervention in laparoscopic sleeve gastrectomy.

Cited by 5 publications

References 21 publications

Staple Line Bleeding Control with Monopolar Cautery in Laparoscopic Sleeve Gastrectomy

Staple Line Bleeding Control with Monopolar Cautery in Laparoscopic Sleeve Gastrectomy

Standardised Sleeve Gastrectomy Without Reinforcement

Gastrectomie longitudinale

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