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Application of Hemostatic Devices in Laparoscopic Hepatectomy
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Improving Hemostasis in Sleeve Gastrectomy With Alternative Stapler.

James G Redmann1, Thomas E Lavin1, Matthew S French1

  • 1Surgical Specialists of Louisiana, Metairie, LA.

JSLS : Journal of the Society of Laparoendoscopic Surgeons
|January 15, 2021
PubMed
Summary

The AEON™ Endostapler resulted in significantly less staple line bleeding during laparoscopic sleeve gastrectomy compared to the Echelon Flex™ Powered Stapler. This suggests AEON™ may improve surgical outcomes by reducing bleeding complications.

Keywords:
ComplicationsHemostasisSleeve gastrectomySurgical stapler

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Area of Science:

  • Bariatric Surgery
  • Minimally Invasive Surgery
  • Surgical Technology

Background:

  • Staple line bleeding is a common complication in laparoscopic sleeve gastrectomy.
  • This bleeding can necessitate interventions that compromise staple line integrity.
  • Improved stapler technology is needed to reduce bleeding and enhance patient safety.

Purpose of the Study:

  • To compare the efficacy of the AEON™ Endostapler versus the Echelon Flex™ Powered Stapler in controlling staple line bleeding during laparoscopic sleeve gastrectomy.
  • To evaluate the impact of stapler choice on intra-operative bleeding and the need for additional hemostatic measures.

Main Methods:

  • A prospective study involving 60 laparoscopic sleeve gastrectomy procedures.
  • Thirty procedures utilized the AEON™ Endostapler (THICK MODE), and 30 used the Echelon Flex™ Powered Stapler (pulse technique).
  • Intra-operative staple line bleeding was quantitatively assessed using a blinded evaluator's "bleeding score" based on laparoscopic imaging.

Main Results:

  • The AEON™ Endostapler group showed a significantly lower mean "bleeding score" (2.1) compared to the Echelon Flex™ group (2.6) (p = 0.01).
  • 50% of AEON™ cases had no fundic bleeding, versus 23% for Echelon Flex™.
  • Profuse bleeding occurred in 0% of AEON™ cases, compared to 7% in the Echelon Flex™ group.

Conclusions:

  • The AEON™ Endostapler provides a significantly drier staple line than the Echelon Flex™ Powered Stapler.
  • This improved hemostasis may reduce the need for supplementary bleeding control techniques.
  • AEON™ Endostapler represents a promising advancement for laparoscopic sleeve gastrectomy outcomes.