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Technical Tricks for Safer Laparoscopic Sleeve Gastrectomy

Derya S Uymaz, MD1, Orhan Agcaoglu, MD1, Onur Bayram, MD1, Cagri Bilgic, MD1, Gorkem K Ozgen, MD2, Yunus Yavuz, MD1. 1Koc University, School of Medicine, Department of General Surgery, 2VM Medical Park Hospital, Bahcesehir

Background: Laparoscopic sleeve gastrectomy can lead to serious complications. However, some technical tricks may help reducing the most frightened complications like leakage or bleeding.

Methods: One hundred and fifty five operations performed with a standart technique at American Hospital and Koc University Hospital by the same surgeon were included in this presentation. In this technique, a 36 F calibration tube was utilized and a four centimeter of distal antrum was preserved. After the initial stapling with 4.5 mm staples, remaining resection was performed with 3.5 mm staples. The jaws of the stapler were compressed for at least two minutes before firing. Whole staple line was imbricated with an absorbable 3/0 self-locking suture over which a fibrin glue was applied. A suction drain was placed along the staple line. On the postoperative day two, an upper gastrointestinal series with water soluable contrast material was performed.

Results: Eighty three patients were female (53.5%), 72 were male (46.5%) and the mean age of the patients was 38.5. Median body mass index was 45.3 kg/m2 and median excess weight was 58.9 kg. Except for a bleeding on the postoperative day 2 due to which a laparotomy was performed, there was no other complications

Conclusion: Longer compression time before firing the stapler, suturing the staple line and the use of the fibrin glue may minimize the complication risks and contribute to the safety during laparoscopic sleeve gastrectomy procedures.


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

Abstract ID: 80079

Program Number: P482

Presentation Session: Poster (Non CME)

Presentation Type: Poster

40

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