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Minerva Chirurgica 2018 Feb 01

DOI: 10.23736/S0026-4733.18.07627-7

Copyright © 2018 EDIZIONI MINERVA MEDICA

lingua: Inglese

Staple line reinforcement during sleeve gastrectomy: with a new type of reinforced stapler

Imad EL MOUSSAOUI , Augustin LIMBGA, Abdelilah MEHDI

Department of Bariatric Surgery, Free University of Brussels, Etterbeek-Ixelles Hospital, Brussels, Belgium


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BACKGROUND: Bleeding and staple-line leak, are the most common complications of laparoscopic sleeve gastrectomy. To decrease the incidence of this complications, a variety of intra-operative reinforcement of staple line are used. Reinforced GIA is a new automatic suture device with pre-attached synthetic tissue reinforcement, but no study has evaluated its use in sleeve gastrectomy. The objective of this study is to evaluate the efficacy and safety of this new staple line reinforcement technique in laparoscopic sleeve gastrectomy.
METHODS: We conducted a retrospective review of 290 patients who underwent laparoscopic sleeve gastrectomy between January 2013 and January 2016 in which Reinforced GIA or standard GIA was used. Patients preoperative characteristics, Operative time, staple line leaks, staple line bleeds, stenosis, and complications requiring reoperation were collected.
RESULTS: 187 laparoscopic sleeve gastrectomy were performed with standard GIA and 103 with Reinforced GIA. Patient characteristics were not significantly different between the groups. The average operating time in the standard GIA group is 57.41 ± 16.44 min against 50.9 ± 14.12 min in the Reinforced GIA group (p = 0.006). Two staple line leaks developed in the standard GIA group and reoperated against no patients in the Reinforced GIA group, without significant difference between the both groups (p = 0.66). Staple line bleeds are less in the Reinforced GIA group, only 23 (22,3%) against 78 (41,7%) cases in the standard GIA group (p = 0.001). No patients of both groups developed gastric sleeve stenosis.
CONCLUSIONS: During laparoscopic sleeve gastrectomy, the use of Reinforced stapler statistically reduces the operative time and staple line bleeding. No significant difference is evidenced in terms of reduction of staple line leaks with this reinforced stapler.


KEY WORDS: Laparoscopic sleeve gastrectomy - Leak - Staple line bleeding

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Publication History

Article first published online: February 01, 2018
Manuscript accepted: January 31, 2018
Manuscript received: January 8, 2018

Per citare questo articolo

El Moussaoui I, Limbga A, Mehdi A. Staple line reinforcement during sleeve gastrectomy: with a new type of reinforced stapler. Minerva Chir 2018 Feb 01. DOI: 10.23736/S0026-4733.18.07627-7

Corresponding author e-mail

Dr.elmoussaoui.imad@gmail.com