Comparative study of non reinforced staple line and reinforced staple line during laparoscopic sleeve gastrectomy

Abstract

Background: Staple line bleeding & leak are the most annoying events of Laparoscopic Sleeve Gastrectomy. Staple line reinforcement (SLR) is considered a weapon to reduce the incidence of such dangerous events. Purpose: Rationale of this study is to compare between non reinforced and reinforced staple line with vicryl sutures during laparoscopic sleeve gastrectomy. Patients and methods: Patients were divided into two groups; group (A); 25 cases; underwent Laparoscopic Sleeve Gastrectomy (LSG) with strength­ening of the stapler line by v-lock suture and group (B); 25 cases; underwent LSG without reinforcement of stapler line. patient follow-up period was 12 months. Results: There were no significant differences between both groups as regard to patient demographic data and hospital stay. Group (A) was performed in longer time; 102 ± 9 vs 74 ± 4 in group (B). frequency of bleeding was more in group (B); 7 patients (28%) than in group (A); one patient (4%). Also frequency of leakage was more group (B); 6 patients (24%) than in group (A); no patients (0%). P-value was for bleeding and leakage; 0.049 & 0.022. Conclusions: Sleeve gastrectomy by laparoscopy is a safe, minimally invasive and easy operative procedure. Adding reinforcement of the whole staple line is easy method to reduce the rate and severity of the postoperative bleeding and leakage to a great extent. Additional cost due to invaginating the whole staple line may be counterbalanced by the reduction in the length of hospital stay.