A Comparison of a Single Center’s Experience with Three Staple Line Reinforcement Techniques in 1,502 Laparoscopic Sleeve Gastrectomy Patients

Abstract

A comparison of imbrication, BPS, and APM demonstrated significantly increased readmission and reoperation rates with a trend towards increased leak rates with the use of BPS in LSG patients. Hemorrhage was not statistically different between the three reinforcement techniques.

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

“…Staple line reinforcement, especially for bariatric surgery, is a topic of debate and growing interest. Several strategies, including the use of glue, have been used to prevent and decrease complications and also to manage them when they occur …”

Hospital variation in perioperative complications for laparoscopic sleeve gastrectomy in Michigan

“…14 Existing evidence shows that higher procedure volumes are associated with improved clinical outcomes for this technically challenging operation. 7–9 On the other hand, sleeve gastrectomy—which has gained an increasingly larger share of the bariatric surgery market in recent years 1, 2 —may be a less complex procedure to perform. Nonetheless, similar to earlier literature that describes variation in hospital complication rates primarily for gastric bypass, 3 this study highlights persistent variation in outcomes for laparoscopic sleeve gastrectomy, currently the most common bariatric operation.…”

“…1, 2 Adjustable gastric banding has become notably less popular over the past decade, and gastric bypass has increasingly surrendered market share to sleeve gastrectomy. 1 Previously, significant concerns existed regarding hospital variation in perioperative safety for bariatric surgery.…”

Prospective evaluation of routine early computed tomography scanner in laparoscopic sleeve gastrectomy

“…This rate may be partially explained by the fact that a systematic CT scan was routinely performed at POD 2. We did not use staple line reinforcement (oversewing, buttressing material, or biologic glue), since no clear benefit in terms of staple line leak prevention or occurrence of hemorrhagic complications has been reported [27,28]. To prevent staple line bleeding, we sustain steady compression on the staple device before firing to wash out fluid from the tissues [29] and perform meticulous hemostasis of the mucosa on the staple line using bipolar coagulation.…”