A disposable gastric clamp has been available for bariatric surgeons in attempt to eliminate variability in shape of stomach (gastric pouch) after vertical sleeve gastrectomy (VSG) and standardize performance of the operation for approximately 18 months. It has been adopted into the approach to VSG at our institution. This is a retrospective review of our experience to determine if the gastric pouch has consistent appearance and if there have been any adverse events as a result of adoption of this technique.
We conducted a retrospective chart review of all patients having VSG at our institution after adoption of the clamp. We reviewed operative reports to determine number of staple loads and both hospital and office records to determine if there were any postoperative complications.
136 consecutive patients had laparoscopic VSG at our institution between November 29, 2017 and May 8, 2019 utilizing the clamp. A single surgeon performed all operations. All patients had fixation of the stomach with the clamp with an 18 french orogastric tube in place in preparation for stapling. There have been no intraoperative staple line misadventures. There were no leaks and no staple line bleeds. Average number of loads required to complete gastrectomy was 4 loads. All patients had esophagram on postoperative day 1.
The literature demonstrates significant variability in technique performing VSG. In our practice, utilization of the clamp has reduced the number of staple loads used, created more consistency in appearance of the gastric pouch on radiographic studies and resulted in no adverse events.