The Risk of Leakage and Bleeding After Using the Ezisurg Endostapler Technique for Bariatric Surgery

Obesity is a growing global health issue, with a prevalence rate of 28.8% in Jordan. Bariatric surgery is the most effective treatment for morbid obesity, yet complications such as postoperative bleeding and leakage remain significant concerns. This study evaluates the safety and effectiveness of the Ezisurg endostapler (Ezisurg Medical, Shanghai, China) in laparoscopic bariatric surgery by assessing the prevalence of these complications.

A retrospective, single-center study was conducted at King Hussein Medical Hospital, Amman, Jordan. Records of 400 consecutive patients who underwent laparoscopic bariatric surgery between September 2023 and August 2024 were reviewed. Intraoperative assessment of leakage was conducted using CT scans with methylene blue test, while postoperative leakage was evaluated through Gastrografin testing and abdominal CT scans. Bleeding was assessed according to the Bleeding Academic Research Consortium (BARC) criteria. Data on patient demographics, procedure types, intraoperative and postoperative complications, and outcomes were systematically collected. Qualitative variables were summarized through frequencies and percentages, while quantitative variables were described with measures of median and interquartile range (IQR). A p-value of <0.05 was considered statistically significant.

A total of 400 patients, predominantly women (80%), with a median age of 34.0 years and a median body mass index (BMI) of 43.0 kg/m² were included. Around two-thirds of patients underwent laparoscopic sleeve gastrectomy (LSG), and the other third underwent laparoscopic Roux-en-Y gastric bypass (LRYGB). The median operation time was 96 minutes. Postoperative complications occurred in 10 patients (3.6%), including bleeding in five patients (1.25%) and leakage in three patients (0.75%). Five (1.25%) patients had postoperative bleeding, of which two were treated conservatively and three required surgical reoperation, two at the trocar site and one at the stapler line.

The Ezisurg endostapler showed low rates of postoperative bleeding (1.25%) and leakage (0.75%), highlighting its safety and effectiveness in laparoscopic bariatric surgery. Multicenter studies and long-term follow-ups are recommended to confirm these findings, evaluate cost-effectiveness, and explore patient-specific risk factors to further improve outcomes.