Abstract
Staple line complications and axial rotation of the gastric tube after sleeve gastrectomy are well-recognized complications of the procedure. The present study aims to investigate the role of staple line inversion and distal fixation to the transverse mesocolon in reducing these complications.
This is a retrospective analysis of prospectively collected data of 252 patients with morbid obesity who underwent laparoscopic sleeve gastrectomy (LSG). Patients were subdivided into two groups: group I comprising 124 patients did not have distal sleeve fixation and group II comprising 128 patients underwent staple line inversion and distal fixation.
Patients were 171 females and 81 males with a mean age of 33.2 +/- 8.7 years and a mean preoperative body mass index (BMI) of 50.9 +/- 8.6 Kg/m(2). The mean operating time was 103.9 +/- 26.9 min and the median hospital stay was 1 day. Major complications were detected in 15 (5.9 %) patients, who were all in group I. Group I had significantly shorter operative time and significantly higher rates of staple line bleeding (4 % in group I versus 0 in group II) and gastric axial rotation (5.6 % in group I versus 0 in group II). There were no significant differences between the two groups regarding early postoperative vomiting (21.7 % versus 26.5 %) and staple line leak (2.4 % versus 0).
Staple line inversion and distal fixation to the transverse mesocolon can be a simple, effective strategy to prevent staple line bleeding, and gastric axial rotation, though it prolonged the operative time of LSG.