Laparoscopic sleeve gastrectomy has become the most commonly performed first bariatric surgery worldwide. However, staple line bleeding and leaks are the main complications after laparoscopic sleeve gastrectomy. This study is an initial experience of laparoscopic sleeve gastrectomy comparing over-sewing and clip reinforcement of staple line for morbid obesity.
Preliminary experience with laparoscopic sleeve gastrectomy in 15 patients with morbid obese was introduced. They were non-randomized into two groups. In the over-sewing group, staple line was invaginated with interrupted seromuscular suturing using 3/0 black silk (Covidien, Mansfield, MA, USA). In clip reinforcement group, the laparoscopic surgical clip was applied on the cross point of the staple line.
Operation time was longer in the over-sewing group, but there was no significant difference statistically (123 min vs 108 min respectively p=0.175). Blood loss (38ml vs 40ml respectively) and length of hospital stay (5.3 days vs 5.6 days respectively) were also similar statistically. There was no significant leak and bleeding in both groups. Only one patient in the over-sewing group had a symptom of nausea and vomiting after sleeve gastrectomy, but there was no stricture in gastrografin swallowing test and fully recovered spontaneously.
Both over-sewing and clip reinforcement of staple line during laparoscopic sleeve gastrectomy were feasible and useful methods to prevent main surgical complications in terms of leaks and bleeding.