Correct Stapling Technique in Laparoscopic Sleeve Gastrectomy: Are We Increasing the Bleeding? A Prospective Cohort...

Area of Science:

• Bariatric Surgery
• Surgical Complications
• Gastrointestinal Surgery

Background:

• Laparoscopic sleeve gastrectomy (LSG) is the most prevalent bariatric surgery.
• Bleeding, primarily from the staple line, is the most frequent complication following LSG.

Purpose of the Study:

• To investigate if a delay between compression and firing during stapling in LSG can decrease postoperative bleeding.
• To assess the impact of a 30-second waiting period on staple line hemostasis.

Main Methods:

• Prospective analysis of 325 patients undergoing LSG from April to July 2022.
• Comparison of postoperative bleeding rates between a group with a 30-second wait and a control group without a wait during stapling.
• Patient demographics included mean age of 37.36 years and mean BMI of 45.18 kg/m².

Main Results:

• The incidence of hemorrhagic complications was significantly lower in the group with the 30-second wait (1.11%) compared to the no-wait group (6.21%) (P=.012).
• Eleven patients required blood transfusion.
• The surgical duration was approximately 10 minutes longer in the group that incorporated the waiting period (P=.0001).

Conclusions:

• Implementing a 30-second pause between compression and firing during the stapling phase of LSG is an effective strategy to reduce postoperative bleeding.
• This technique modification offers improved patient safety without significantly compromising surgical efficiency.