Staple-Line Reinforcement in Sleeve Gastrectomy

To compare the frequency of postoperative complications, specifically staple-line bleeding and leakage, in patients undergoing laparoscopic sleeve gastrectomy (LSG) with and without staple-line reinforcement.

A descriptive, analytical study. Place and Duration of the Study: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from January 2014 to December 2024.

Patients aged 20 to 60 years, of either gender, who underwent LSG were retrospectively reviewed. A binary logistic regression was conducted to assess the association between staple-line reinforcement and postoperative bleeding, adjusting for age, gender, diabetes mellitus, hypertension, and smoking status. Results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). A p-value of <0.05 was considered statistically significant. Model fit and multicollinearity were assessed before finalising the regression model.

Staple-line reinforcement was not found to have a significant association with the reduced postoperative bleeding (OR = 0.636, 95% CI: 0.206-1.964, p = 0.432). No post-operative leakage was noted in either group.

Staple-line reinforcement during LSG does not significantly reduce the incidence of postoperative bleeding or leakage. These findings suggest that the use of staple-line reinforcement material may not be essential when meticulous surgical technique is employed. Further large-scale prospective studies are recommended to confirm these results and refine surgical protocols.

Laparoscopic sleeve gastrectomy, Staple-line reinforcement, Bleeding, Leakage, Bariatric surgery.