Over-the-Scope Clip (OTSC) System for Sleeve Gastrectomy Leaks

Area of Science:

• Bariatric Surgery
• Gastroenterology
• Endoscopic Interventions

Background:

• Laparoscopic sleeve gastrectomy (LSG) is a common bariatric procedure for morbid obesity.
• Staple-line leaks are a significant complication of LSG, occurring in 0.5-7% of patients.
• The Over-the-Scope Clip (OTSC) system is a novel endoscopic device used for managing gastrointestinal defects.

Purpose of the Study:

• To evaluate the efficacy and safety of the Over-the-Scope Clip (OTSC) system in treating staple-line leaks following laparoscopic sleeve gastrectomy (LSG).

Main Methods:

• A retrospective analysis of prospectively collected data from patients who underwent endoscopic OTSC treatment for LSG leaks.
• Efficacy was defined as achieving complete oral nutrition without evidence of additional leakage.

Main Results:

• Twenty-six patients were treated with the OTSC system for LSG leaks.
• The median age was 39 years, with a mean BMI of 42.89 kg/m².
• Eighty-four percent of leaks were upper staple-line leaks near the gastroesophageal junction.
• Twenty-one patients (80.76%) achieved successful treatment, reaching complete oral nutrition within a median of 32 days.
• Five treatment failures occurred (two with lower antral leaks, three with upper staple-line leaks).

Conclusions:

• The Over-the-Scope Clip (OTSC) system demonstrates a high success rate in treating staple-line leaks after laparoscopic sleeve gastrectomy.
• The OTSC system is concluded to be a safe and effective endoscopic treatment option for LSG leaks.