Abstract
Background: Laparoscopic sleeve gastrectomy (LSG) can present some complications such as bleeding and leakage. While leaks originate at the level of the staple line, some hemorrhages too, but not exclusively. This motivated the development of techniques to reduce them. Those techniques would be staple-line reinforcement (SLR) and omentopexy.
Several studies report that reinforcement reduces complications. However, some surgical teams decide not to use it. The waste of operating time, costs, and a longer learning curve are the principal disadvantages.
In this chapter, we analyzed several methods to reduce postoperative LSG complications.
Conclusion: There are several techniques to reduce the complications at the level of the staple line in LSG. The application of SRL reduced the rate of postoperative complications.
We opine that the operating surgical team should opt for the type of treatment that is most effective.
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References
Carandina S, Montana L, Danan M, et al. Laparoscopic sleeve gastrectomy learning curve: clinical and economical impact. Obes Surg. 2018; https://doi.org/10.1007/s11695-018-3486-3. [Epub ahead of print]
Doumouras AG, Saleh F, Gmora S, et al. The value of surgical experience: excess costs associated with the Roux-en-Y gastric bypass learning curve. Surg Endosc. 2018; https://doi.org/10.1007/s00464-018-6472-x. [Epub ahead of print].
Trastulli S, Desiderio J, Guarino S, et al. Laparoscopic sleeve gastrectomy compared with other bariatric surgical procedures: a systematic review of randomized trials. Surg Obes Relat Dis. 2013;9(5):816–29.
D’Ugo S, Gentileschi P, Benavoli D, et al. Comparative use of different techniques for leak and bleeding prevention during laparoscopic sleeve gastrectomy: a multicenter study. Surg Obes Relat Dis. 2014;10(3):450–4.
Baker RS, Foote J, Kemmeter P, et al. The science of stapling and leaks. Obes Surg. 2004;14(10):1290–8.
Gagner M, Deitel M, Kalberer TL, et al. The second international consensus summit for sleeve gastrectomy, March 19 – 21, 2009. Surg Obes Relat Dis. 2009;5:476–85.
Clinical Issues Committee of American Society for Metabolic and Bariatric Surgery. Updated position statement on sleeve gastrectomy as a bariatric procedure. Surg Obes Relat Dis. 2010;6:1–5.
Glaysher M, Khan OA, Mabvuure NT, et al. Staple line reinforcement during laparoscopic sleeve gastrectomy: does it affect clinical outcomes? Int J Surg. 2013;11(4):286–9.
Choi YY, Bae J, Hur KY, et al. Reinforcing the staple line during laparoscopic sleeve gastrectomy: does it have advantages? A meta-analysis. Obes Surg. 2012;22(8):1206–13.
Wang Z, Dai X, Xie H, et al. The efficacy of staple line reinforcement during laparoscopic sleeve gastrectomy: a meta-analysis of randomized controlled trials. Int J Surg. 2016;25:145–52.
Zafar SN, Felton J, Miller K, et al. Staple line treatment and bleeding after laparoscopic sleeve gastrectomy. JSLS. 2018;22(4)
Demeusy A, Sill A, Averbach A. Current role of staple line reinforcement in 30-day outcomes of primary laparoscopic sleeve gastrectomy: an analysis of MBSAQIP data, 2015-2016 PUF. Surg Obes Relat Dis. 2018;14(10):1454–61.
Gagner M, Buchwald JN. Comparison of laparoscopic sleeve gastrectomy leak rates in four staple-line reinforcement options: a systematic review. Surg Obes Relat Dis. 2014;10(4):713–23.
Shikora SA, Mahoney CB. Clinical benefit of gastric staple line reinforcement (SLR) in gastrointestinal surgery: a meta-analysis. Obes Surg. 2015;25(7):1133–41.
Al Hajj GN, Haddad J. Preventing staple-line leak in sleeve gastrectomy: reinforcement with bovine pericardium vs. oversewing. Obes Surg. 2013;23(11):1915–21.
Serra E, Jacob CE. Optimizing the staple line. In: Lutfi R, Palermo M, Cadière G-B, editors. Global bariatric surgery. 1st ed. Switzerland: Springer; 2018. p. 341–8.
El Chaar M, Stoltzfus J. Assessment of sleeve gastrectomy surgical technique: first look at 30-day outcomes based on the MBSAQIP database. J Am Coll Surg. 2018;227(6):564–72.
Shah SS, Todkar JS, Shah PS. Buttressing the staple line: a randomized comparison between staple-line reinforcement versus no reinforcement during sleeve gastrectomy. Obes Surg. 2014;24(12):2014–20.
Yo LS, Consten EC, Quarles van Ufford HM, et al. Buttressing of the staple line in gastrointestinal anastomoses: overview of new technology designed to reduce perioperative complications. Dig Surg. 2006;23(5–6):283–91.
Consten EC, Gagner M, Pomp A, et al. Decreased bleeding after laparoscopic sleeve gastrectomy with or without duodenal switch for morbid obesity using a stapled buttressed absorbable polymer membrane. Obes Surg. 2004;14(10):1360–6.
Gentileschi P, D'Ugo S, Benavoli D, et al. Staple-line reinforcement with a thrombin matrix during laparoscopic sleeve gastrectomy for morbid obesity: a case series. J Laparoendosc Adv Surg Tech A. 2012;22(3):249–53.
Chakravartty S, Sarma DR, Chang A, et al. Staple line bleeding in sleeve gastrectomy-a simple and cost-effective solution. Obes Surg. 2016;26(7):1422–8.
Karaman K, Aziret M, Ercan M, et al. A preventive strategy for staple line bleeding in morbidly obese patients undergoing sleeve gastrectomy. J Laparoendosc Adv Surg Tech A. 2017;27(10):1015–21.
Afaneh C, Costa R, Pomp A, et al. A prospective randomized controlled trial assessing the efficacy of omentopexy during laparoscopic sleeve gastrectomy in reducing postoperative gastrointestinal symptoms. Surg Endosc. 2015;29(1):41–7.
Arslan E, Banli O, Sipahi M, et al. Effects and results of omentopexy during laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech. 2018;28(3):174–7.
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Davrieux, C.F., Palermo, M., Shahbaz, M., Gagner, M. (2020). Staple-Line Reinforcement and Omentopexy. In: Gagner, M., Cardoso, A., Palermo, M., Noel, P., Nocca, D. (eds) The Perfect Sleeve Gastrectomy. Springer, Cham. https://doi.org/10.1007/978-3-030-28936-2_8
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DOI: https://doi.org/10.1007/978-3-030-28936-2_8
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