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LSG: One minute to fire is better than 20 secs?

Mirto Foletto, MD, Pasquale Auricchio, MD, Mostafa Altowerqi, MD, Alice Albanese, MD. University of Padua

Introduction: Laparoscopic Sleeve Gastrectomy  (LSG) is one of the most popular bariatric procedure, with good outcomes in terms of weight loss and comorbidities resolution in the mid- and long-term.

Staple line bleeding is one of the major related complications, occurring  in 1- 4% of cases. Adequate tissue compression is considered of utmost importance to create a good staple line

Objectives: To evaluate the impact of the time of stapler closure before firing on staple line bleeding.

Methods: From January to August 2018,  116 patients (mean age 43 years old, F 69, M 47, mean BMI 40 Kg/m²) underwent LSG at our Institution. In 57 patients stapler was kept closed for 60 seconds (group 1) before firing, while in the remaining 59 the time of compression was 20 seconds (group 2). Mean operative time, Haemoglobin loss (DHb) and drainage output (ml) in 1st and 2nd post-operative day (POD) were collected and compared. P< 0,005 was considered significative.

Results: DHb (pre-op vs POD1) resulted higher in group 1 (10.9 ± 0.07 vs  8.01 ± 0.7 ; P=0,0001). The same was observed for  drainage output in POD 1 and 2 (81.3 ± 48.37   vs.  57.5 ± 9.37, p=0.003; 70.9 ± 51.7 vs 67.88 ± 9.38 ml, p=0.001 ).

Mean operative time  was shorter in group 1 (63.2±13.9 min  vs 68.7 ±9.3 min, p = 0.001).

Conclusions: According to our experience, the longer time of tissue compression before stapler firing  reduce intra-operative staple line bleeding during and mean operative time, but doesn’t affect Hb changes in the early post-operative period (POD1 and 2).


Presented at the SAGES 2017 Annual Meeting in Houston, TX.

Abstract ID: 95026

Program Number: P046

Presentation Session: Poster Session (Non CME)

Presentation Type: Poster

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