Laparoscopic Sleeve Gastrectomy with T-Shaped Omentoplasty: Impact on the Early Postoperative Outcomes

Abstract

Purpose

Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric procedure, yet can be followed by complications such as staple line leak and bleeding, vomiting, and gastroesophageal reflux disease (GERD). Various attempts have been described in the literature to improve the early outcome of LSG through various measures. This study aimed to assess the impact of adding T-shaped omentoplasty to LSG on the short-term outcome of the procedure.

Methods

This was a retrospective cohort study on patients with morbid obesity who underwent LSG in the period of November 2015 to November 2018. The outcome of patients with morbid obesity who underwent LSG combined with T-shaped omentoplasty (group I) was compared with that of a similar number of patients who underwent classical LSG without staple line fixation (group II). The main outcome measures were the rates of staple line bleeding and leak, postoperative nausea and vomiting (PONV), GERD, gastric axial rotation, other complications, and weight loss.

Results

The study included 106 patients of a mean BMI of 49.8 kg/m2. Group II had significantly higher PONV) scale at 1 week and 1 month than group I. Group I had significantly lower rates of staple line bleeding (0 vs 9.6%, p = 0.02) and GERD (3.7% vs 17.3%, p = 0.02) than group II. Both groups had similar rates of staple line leak and comparable operation time.

Conclusion

Staple line fixation using the T-shaped omentoplasty technique was associated with lower incidence of significant PONV, staple line bleeding, and GERD as compared with classical LSG.

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Affiliations

Authors

Contributions

Emad Abdallah designed the study. Emad Abdallah, Mahmoud Zakaria, Mahmoud Abdelnaby, Sabry Mahmoud, Waleed Gado, and Samy Elbaz followed the patients, collected the data, and critically revised the manuscript. Sameh Emile and Mohamed Fikry participated in data collection and analysis and writing and revision of the manuscript.

Corresponding author

Correspondence to Sameh Hany Emile.

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The authors declare that they have no conflict of interest.

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All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards. Ethical approval for the study was obtained from the Research Ethics Committee.

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Informed consent does not apply as for this type of study; formal consent is not required.

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Abdallah, E., Zakaria, M., Fikry, M. et al. Laparoscopic Sleeve Gastrectomy with T-Shaped Omentoplasty: Impact on the Early Postoperative Outcomes. OBES SURG 30, 3735–3741 (2020). https://doi.org/10.1007/s11695-020-04743-6

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Keywords

  • Sleeve gastrectomy
  • Staple line fixation
  • T-shaped
  • Omentoplasty
  • Short-term