Related Experiment Video
Updated: Jul 4, 2026
09:40
An Ivor Lewis Esophagectomy Designed to Minimize Anastomotic Complications and Optimize Conduit Function
Published on: April 17, 2020
Clinical results using bioabsorbable staple line reinforcement for circular staplers
Wesley B Jones1, Katherine M Myers, L Brannon Traxler
1Academic Department of Surgery, Greenville Hospital System University Medical Center, Greenville, South Carolina, USA. joneswesley@bellsouth.net
The American Surgeon
|June 18, 2008
Summary
Circular staple line reinforcement significantly reduces gastrojejunal anastomotic strictures and complications in gastric bypass surgery. This bariatric surgery technique improves patient outcomes by lowering stricture rates by 93%.
Area of Science:
- Bariatric Surgery
- Surgical Technology
- Gastrointestinal Surgery
Background:
- Linear staple line reinforcement is established for colorectal surgery.
- Benefits of circular staple line reinforcement in bariatric surgery are not well-documented.
- Anastomotic complications are a concern in gastric bypass procedures.
Purpose of the Study:
- To compare anastomotic bleeding, leak, and stricture rates in laparoscopic gastric bypass patients with and without circular staple line reinforcement.
- To evaluate the efficacy of GORE SEAMGUARD bioabsorbable circular staple line reinforcement (CBSG) in reducing complications.
- To assess the impact of CBSG on overall anastomotic integrity.
Main Methods:
- Retrospective comparison of 138 patients (Group B) with CBSG versus 255 patients (Group A) without reinforcement.
- Laparoscopic Roux-en-Y divided gastric bypass with a 25-mm circular stapled gastrojejunal anastomosis.
- Mean follow-up periods of 9 months (Group B) and 22 months (Group A).
Main Results:
- Anastomotic bleeding rates: 0.7% (CBSG) vs. 1.1% (no reinforcement) (P=0.64).
- Anastomotic leak rates: 0.7% (CBSG) vs. 1.9% (no reinforcement) (P=0.34).
- Anastomotic stricture rates: 0.7% (CBSG) vs. 9.3% (no reinforcement) (P=0.0005).
- CBSG reduced stricture incidence by 93% and composite anastomotic complications by 85%.
Conclusions:
- Circular staple line reinforcement significantly decreases anastomotic stricture incidence after laparoscopic gastric bypass.
- CBSG use leads to a substantial reduction in overall anastomotic complications.
- Routine consideration of CBSG is recommended for circular stapled gastrojejunal anastomoses in gastric bypass surgery.
