Laparoscopic Sleeve Gastrectomy for Morbid Obesity with Intra-operative Endoscopy: Lessons We Learned After 100 Consecutive Patients

Alexandrou, Andreas; Michalinos, Adamantios; Athanasiou, Antonios; Rosenberg, Theofilos; Christos, Tsigris; Diamantis, Theodoros

doi:10.1007/s11695-014-1524-3

Cited by 20 publications

(25 citation statements)

References 19 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…A meta-analysis reported that, in %EWL terms, bariatric surgery is more effective in Caucasians than in blacks, regardless of procedure type [33]. Studies on LSG have also reported that the weight loss outcomes were significantly less favorable for super-obese patients as well as older patients [34][35][36].…”

Section: Discussionmentioning

confidence: 99%

Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asian cohort

Ching

Cheng

Kong

et al. 2016

Surgery for Obesity and Related Diseases

View full text Add to dashboard Cite

Section: Discussionmentioning

confidence: 99%

Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asian cohort

Ching

Cheng

Kong

et al. 2016

Surgery for Obesity and Related Diseases

View full text Add to dashboard Cite

“…After removing duplicates (n = 79), the 1554 records were screened by title and abstract after which 1179 were excluded and the full-text articles for the remaining 375 records were assessed for eligibility. A total of 148 papers were included in the final analysis and the number of studies per reinforcement method were: 69 for NO-SLR [9, 17-84], 70 for suture [9,19,20,22,26,30,46,51,53,75,76,78,83,, 9 for BPS [9,72,78,83,86,89,[141][142][143], 9 for Seal [9,30,61,74,78,103,[144][145][146], and 24 for APM [9,39,52,53,63,89,103,131,[147][148][149][150][151][152][153][154][155][156][157][158][159][160]…”

Section: Study Characteristicsmentioning

confidence: 99%

Comparison of laparoscopic sleeve gastrectomy leak rates in five staple-line reinforcement options: a systematic review

2019

View full text Add to dashboard Cite

Background Staple-line leaks following laparoscopic sleeve gastrectomy (LSG) remain a concerning complication. Stapleline buttressing is largely adopted as an acceptable reinforcement but data regarding leaks have been equivocal. This study compared staple-line leaks in five reinforcement options during LSG: no reinforcement (NO-SLR), oversewing (suture), nonabsorbable bovine pericardial strips (BPS), tissue sealant or fibrin glue (Seal), or absorbable polymer membrane (APM). Methods This systematic review study of articles published between 2012 and 2016 regarding LSG leak rates aligned with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. Variables of interest included leak rates, bleeding, and complications in addition to surgical and population parameters. An independent Fisher's exact test was used to compare the number of patients with and without leaks for the different reinforcement options. Results Of the 1633 articles identified, 148 met inclusion criteria and represented 40,653 patients. Differences in age (older in APM; p = 0.001), starting body mass index (lower in Suture; p = 0.008), and distance from pylorus (closer in BPS; p = 0.04) were observed between groups, but mean bougie size was equivalent. The overall leak rate of 1.5% (607 leaks) ranged from 0.7% for APM (significantly lower than all groups; p ≤ 0.007 for next lowest leak rate) to 2.7% (BPS). Conclusions This systematic review of staple-line leaks following LSG demonstrated a significantly lower rate using APM staple-line reinforcement as compared to oversewing, use of sealants, BPS reinforcement, or no reinforcement. Variation in surgical technique may also contribute to leak rates.

show abstract

“…[3] Conversely, the use of intraoperative endoscopy for the calibration of the stomach has sparsely been reported. [4] The calibration with bougie during LSG is rarely related to complications. [5] However, this technique can lead to complications such as accidental stapling across the tip, staple-line corkscrewing and esophageal perforation (EP).…”

Section: Introductionmentioning

confidence: 99%

Endoscopic management of esophageal perforation caused by calibrating bougie during laparoscopic sleeve gastrectomy

Martines

Digennaro

Fazio

et al. 2017

CSS

View full text Add to dashboard Cite

Background: Laparoscopic Sleeve Gastrectomy (LSG) is one of the most used surgical techniques for the treatment of morbid obesity. The esophageal perforation (EP) secondary to the use of calibrating bougie is a rare complication. Case presentation: A 43-year-old woman with a body mass index (BMI) of 54 kg/m 2 underwent LSG. During the use of a calibrating bougie, a distal EP occurred, but it became evident only during the second day after the surgery. The patient was hospitalized in Intensive Care Unit because of respiratory failure and her clinical conditions did not permit a safe surgical treatment. The EP was treated successfully by endoscopic conservative approach with a double-covered self-expanding endoprosthesis (SEMS).Results: The esophageal calibrating bougie, often placed by an anaesthesiologist, is undoubtedly useful during the learning curve of the surgeon to ensure a correct sleeve size; however, it may result in severe and difficult-to-treat iatrogenic lesions. Conclusions: Managing the complications through conservative endoscopy is possible, but in order to support these patients, the immediate availability of an intensive care unit is essential. We underline the importance of a dedicated team of surgeons and anaesthesiologists and a multidisciplinary team to treat major complications in bariatric surgery.

show abstract

Laparoscopic Sleeve Gastrectomy for Morbid Obesity with Intra-operative Endoscopy: Lessons We Learned After 100 Consecutive Patients

Cited by 20 publications

References 19 publications

Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asian cohort

Early outcomes of laparoscopic sleeve gastrectomy in a multiethnic Asian cohort

Comparison of laparoscopic sleeve gastrectomy leak rates in five staple-line reinforcement options: a systematic review

Endoscopic management of esophageal perforation caused by calibrating bougie during laparoscopic sleeve gastrectomy

Contact Info

Product

Resources

About