Jakrapan Wittayapairoch, MD1, Sakkran Sangkhamanon, MD2, Narong Boonyagard, MD3, Rapheephat Tanomphetsanga, MD3, Kongpon Tangpanitandee, MD3, Krit Kitisin, MD3, Suppa-ut Pungpapong, MD3, Chadin Tharavej, MD3, Patpong Navicharern, MD3, Suthep Udomsawaengsup, MD3. 1Department of Surgery, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 2Department of Pathology, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand, 3Department of Surgery, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Introduction: Sleeve gastrectomy has become more popular in a surgical procedure to treat patients with morbid obesity. An essential part of the procedure is the hemostasis on the staple line. Electrocautery must be applied to staple line precisely. It is still a controversial issue whether postoperative leakage around the staple line would occur.
Method and Procedures: After sleeve gastrectomy was performed, the divided part of the stomach, which was used as a surgical specimen, was studied. Three specimens from three different patients were used in the study. Different spots on the staple line of each specimen were electrocauterized by a monopolar hook in a different period of time: spot cautery, one second, two seconds, three seconds, four seconds and five seconds. A systematic study was conducted; each electrocauterized spot on the staple line was studied in 3 dimensions: two lateral sides, two longitudinal sides and in-depth thermal injury to evaluate tissue injury on the staple line.
Results: Eighty-five pieces of tissue, five on each of seventeen slides, were studied macroscopically and microscopically. Macroscopically, the tissue injury did not exceed the staple line. Microscopically, submucosa, intramuscular hemorrhage and cellular swelling were found in both electrocauterized and non-electrocauterized areas; nevertheless, neither cell death nor structural change was found.
Conclusions: Precisely and carefully performed electrocautery on sleeve gastrectomy staple line is effective for hemostasis and as it has been proved to be safe in this histological study.
Presented at the SAGES 2017 Annual Meeting in Houston, TX.
Abstract ID: 78592
Program Number: P081
Presentation Session: Poster (Non CME)
Presentation Type: Poster
