Healing of the stapled stomach in bariatric operations

Breakdown of the in-continuity gastric staple line after gastroplasty and gastric bypass is frequently associated with either complications or unsatisfactory weight loss. Although there is wide variation in the reported incidence of stale-line disruption after gastric bariatric operations, this complication is most frequently recognized by surgeons who routinely examine the integrity of the staple line at 12 months or more after operation. Upper gastrointestinal contrast studies are more sensitive than upper endoscopy in detecting small defects in the stapled gastric partition. The stomach should be routinely divided in patients who require reoperation for late staple-line disruption. This complication could be prevented by routine transection of the stomach at the initial gastric restrictive operation.