Lisa Y Shimotake, Lisa Dobruskin, MD, Wai Yip Chau, MD. Princeton Healthcare System
BACKGROUND: Bariatric surgery is a rapidly evolving field with a wide variety of techniques. In its infancy, there were several approaches to restricting intake and/or absorption. Over the past decade, sleeve gastrectomy has become the most commonly performed weight loss surgery, comprising 58.4% of bariatric surgeries performed at this time. Although this surgery is relatively standardized, there are variations in techniques that ought to be investigated in order to optimize this and other surgeries for the bariatric population.
OBJECTIVE: In this retrospective observation study, our goal was to compare the classical sleeve gastrectomy to the staple first technique with respect to outcomes and complications. We compared frequency of complications, including anastomotic leakage, pulmonary embolism, MI, and transfusion requirement. We predicted there is no difference between either surgical approach.
METHODS: A database was created through a chart review of a single site with two bariatric surgeons. Each surgeon has different surgical approaches to the gastric dissection when performing laparoscopic sleeve gastrectomy. Patients included in the study underwent laparoscopic sleeve gastrectomy in 2014 through 2016 by either of these surgeons.
RESULTS: A total of 443 patients underwent laparoscopic sleeve gastrectomy in 2014-2016, 214 via the classic approach and 229 via the staple first approach. The classic approach group consisted of 74.3% females and 25.7% males. The staple first approach group consisted of 76.9% females and 23.1% males. Initial BMI for each group were similar, 42.9 for the classic approach and 43.3 for staple first. There were 12 complications, consisting of re-operations, re-admissions, pulmonary embolism, and intra-abdominal infection. Seven of these patients underwent the classic approach, while five underwent the staple first approach, demonstrating a 3.3% and 2.2% complication rates, respectively.
CONCLUSION: It was found that the there is no difference in complication rates between the staple first and classical techniques. Further investigation must be done to compare these and other approaches to the sleeve gastrectomy, as it is rapidly becoming the most popular technique performed in the States.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 88427
Program Number: P608
Presentation Session: iPoster Session (Non CME)
Presentation Type: Poster