Is Laparoscopic Sleeve Gastrectomy Without Staple Reinforcement Safer? Analysis of 426 Consecutive Cases

Laparoscopic Sleeve Gastrectomy (LSG) is an accepted safe procedure and the most common surgical method used in the treatment of morbid obesity. Leakage and staple line bleeding are significant postoperative complications that can cause concern due to the long staple line. The purpose of this study to examine the risk of complications that may arise due to the lack of staple line reinforcement during the surgery.

Between March 2021 and May 2023, 426 consecutive patients who underwent LSG in Avrupa Safak Hospital were identified through a retrospective database. The patients included in the study were divided into two groups according to the staple line reinforcement. Group A (n = 210) received staple line reinforcement (SLR) and Group B (n = 204) received non-staple line reinforcement (NSLR). Twelve patients who did not meet the inclusion criteria were excluded from the study. Patient demographics, operative time, postoperative and perioperative complications such as staple line leak, bleeding, conversion to open surgery, length of hospital stay, abdominal pain, morbidity and mortality-related data were analyzed.

The mean age, body mass index (BMI), and ASA scores were similar in both groups. Operative time was longer in SLR group (p < 0.001). Postoperative complications occurred in 6 (2.9%) and 9 (4.4%) patients in Groups A and B respectively (p = 0.397). There was no staple line leak in either group. There were two strictures in Group A. Mean length of postoperative hospital stay was 2.17 and 2.16 days in Groups A and B respectively (p = 0.830). There was no in patient death.

Reinforcing the staple line after LSG is not necessary to reduce the risk of staple line leaks and bleeding.