Mena Boules, MD, Julietta Chang, MD, Ricard Corcelles, MD, PhD, Dvir Froylich, MD, John Rodriguez, MD, Matthew Kroh, MD. Cleveland Clinic
Objective of technology
Laparoscopic sleeve gastrectomy (SG) is a well established surgical approach, with a surge in popularity because of its excellent excess weight loss and effectiveness in reducing weight related co-morbid conditions. Consensus meetings and published data have improved overall safety and reproducibility of this procedure but complications such as staple line leak, and post-operative bleeding occur. We present a newly developed gastric positioning system aimed at promoting procedural consistency during LSG; combining the ability to size accurately, decompress, and perform leak tests of the gastric sleeve.
Description of technology
GastriSail manufactured by Covidien™, is composed of an axial handle and external markings which are directed to provide orientation and guidance during insertion (Image 1). From the axial handle, two tubes arise which can be described as a large external 36 French tube (main), with a smaller tube embedded within. The smaller tube has LED illuminating capability along its length to guide the surgeon during device deployment, which may optimize device position through better visualization. Deployment of the device positions the main tube along the lesser curve of the stomach to size the sleeve (Image 2). Upon deployment, the device can be visualized in the shape of a “sail”, further positioning the stomach in a non-contracted presentation (Image 3). The device has regulated suction capabilities allowing apposition of the anterior and posterior stomach walls. Additionally, the design of this device includes several perforations along both sides of the distal length of the external tube to allow for decompression, and the ability to perform leak testing.
Preliminary results are unavailable at this time. We intend to present results during the SAGES meeting.
Conclusions / future directions
GastriSail may allow easier sizing during LSG as well as additional tasks including decompression, and leak test. Future studies may focus on the comparison with standard techniques of bougie and endoscopic sizing.