Comparison of Reinforcement Techniques Using Suture on Staple-Line in Sleeve Gastrectomy

Obesity Surgery
Tomasz RogulaPhilip Schauer

Abstract

Sleeve gastrectomy is a common procedure in recent years for treatment of morbid obesity however leak from staple-line is its main challenging complication. Despite numerous studies regarding leak after sleeve gastrectomy, there is still no conclusion on reinforcement of staple-line in this procedure. The purpose of this study was to compare two methods of oversewing staple-line versus no reinforcement. Resected stomachs of 30 patients undergoing laparoscopic sleeve gastrectomy were evaluated for bursting pressure immediately after extraction from the abdomen. Reinforcement technique was applied in random order to 3 segments of the staple-line on each specimen: continuous Lembert's sutures, continuous through-and-through sutures, and no reinforcement. Bursting pressure was determined by injection of methylene blue solution into lumen of resected stomach and recording pressure at which leakage occurs. Location of leak, intragastric pressure, and volume at first leak were recorded. Baseline characteristics of patients were similar in randomized groups for order of reinforcement technique. Mean ischemia time of specimens was 17.4 ± 10.4 min. No leaks were observed in segments reinforced with Lembert's oversewing technique. The thr...Continue Reading

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Citations

Jun 16, 2016·Langenbeck's Archives of Surgery·Angelo IossaGianfranco Silecchia
Jul 31, 2016·The Surgical Clinics of North America·Kellen Hayes, George Eid
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Dec 23, 2017·Obesity Surgery·Matteo CatanzanoMohamed Bekheit

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