Comparative Study Between Inversion and Non Inversion of the Staple Line in LSG

Abstract

Background: Morbid obesity has become a big health problem due to its multiple co-morbidities. Bariatric
surgery proved to be an effective way for management of morbid obesity and its co-morbidities. In recent
years, sleeve gastrectomy (SG) evolved single-stage for treatment of morbid obesity.
Aim of the Work: To compare inversion and non inversion of staple line in LSG as regard: the percentage of
leakage, percentage of bleeding, percentage of thromboembolism and percentage of infection complication.
This comparative randomized study was conducted 40 morbidly obese patients operated upon for LSG 20
without inversion of staple line & 20 with inversion of staple line and are followed up afterwards to evaluate
and postoperative leakage rate in the early six months in Surgery Department, Kasr El-Aini Hospital and
Ahmed Maher Teaching Hospital in the period between August 2015 and August 2016.
Results: There is no statistically significant difference between group A (LSG without inversion of staple
line) and group B (LSG with inversion of staple line) in age(range 23 to 60 years VS 19 to 60 years), mean
BMI (49.49 VS 45.06), co morbidities, time of surgery (124 min VS 108 min) andcomplications which
include:(bleeding,infection, leakage and thromboembolism).
Conclusion: laparoscopic SG is effective treatment for morbid obesity with accepted range of complications.
Reinforcement of staple line has no significant impact on percentage of suture line bleeding or leakage or
on the operative time or hospital stay. This technique can be restricted to special individual cases depending
on the operative findings. However, more intense practice and wide range of cases are required for more
precise assessment.