Paul E Enochs, MD, FACS, FASMBS, Jaime L Bull, CRC, PAS. WakeMed Bariatric Specialists of NC
Objective: Sleeve based procedures now encompass approximately 70% of all bariatric surgeries. Yet with the increasing prevalence of these procedures, a standardized technique has not been established. There are hundreds of variations of techniques all in an attempt to create a straight gastric staple line in the floppy, stretchy, two-sided tissue of the stomach. This creates numerous potential pitfalls and stumbling blocks that can create complications ranging from strictures to spirals to complete obstruction. Other than the skill set and the clinical acumen of the surgeon, a tool does not exist to aid in standardizing the technique of these procedures and thereby help minimize the risk of these potential complications.
Description: The Standard Clamp is a 10 mm laparoscopically placed device that with a 16-18 French nasogastric tube can create a 36-40 French sleeve. The goal of this device is to allow the placement of a series of short staple cartridges on the stomach in a continuous line and in the same plane in order to get a consistent shape while ensuring safe distances from key landmarks. In doing so, it will ensure the staple line has no twists, spirals, strictures, or kinking all of which can lead to obstruction. Finally, holding the stomach firm in a straight line allows for fewer staple cartridges being required, thereby potentially decreasing the overall cost of the procedure.
Preliminary Results: Utilizing our internal practice database and electronic medical record, clinical data were obtained for our initial 25 patients who underwent a primary sleeve-based procedure. An analysis was done evaluating complications associated with the procedure and the number of loads used. This was compared to our established historical data on our sleeve-based procedures. Preliminary results indicate a consistently shaped sleeve utilizing fewer staple loads with no additional morbidity or mortality.
Conclusions/Future Directions: The use of the Standard Clamp in sleeve-based procedures allows for a straighter sleeve, fewer staple loads, and the potential for fewer complications. The use of this device will also help pave the way for the future of a full-length sleeve gastrectomy stapler. Increasing the utilization of this device has the potential to decrease the cost and increase the safety and efficacy of our most common bariatric procedures.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 98906
Program Number: ETP734
Presentation Session: Emerging Technology Poster Session (Non CME)
Presentation Type: Poster