A comparative study between staple line reinforcement during laparoscopic sleeve gastrectomy and no reinforcement: an Egyptian experience

Surg Endosc. 2023 Dec;37(12):9318-9325. doi: 10.1007/s00464-023-10497-w. Epub 2023 Oct 27.

Abstract

Background: Laparoscopic sleeve gastrectomy (LSG) has become an increasingly popular bariatric procedure. LSG still conveys some risks, including early staple line complications such as bleeding and leaks. It has been proposed that staple line complications can be reduced by staple line reinforcement (SLR). This study aimed to compare the short-term efficacy and safety of the SLR during LSG by oversewing versus no SLR in an Egyptian cohort over a period of 11 years.

Patients and methods: This is a retrospective study that analyzed data from patients undergoing LSG by the same surgeon over a period of 11 years. The patients' early postoperative complications were compared according to performing SLR.

Results: The SLR group showed significantly longer surgery time (p = 0.021) and a lower rate of postoperative bleeding (p = 0.027). All leakage cases occurred in the non-SLR group (0.7% vs. 0.0%) without statistical significance (p = 0.212). The two mortality cases occurred in the non-SLR group. The LOS was comparable in the two groups (p = 0.289).

Conclusion: This study confirms the short-term benefits of SLR by oversewing during LSG in terms of a lower incidence of 30-day morbidity, particularly bleeding, and lower rates of reoperation, with a clinically questionable longer operation time.

Keywords: Early postoperative morbidity; Laparoscopic sleeve gastrectomy (LSG); Obesity; Oversewing; Staple line reinforcement (SLR).

MeSH terms

  • Egypt
  • Gastrectomy / methods
  • Humans
  • Laparoscopy* / methods
  • Obesity, Morbid* / surgery
  • Postoperative Complications / epidemiology
  • Postoperative Complications / etiology
  • Postoperative Complications / prevention & control
  • Retrospective Studies
  • Surgical Stapling / methods
  • Treatment Outcome