Laparoscopic Sleeve Gastrectomy: Suture or not Suture Staple Line

Abstract

Background The severity of postoperative complications is the main disadvantage of laparoscopic sleeve gastrectomy (LSG). Staple line reinforcement (SLR) is strongly advocated. Recently, oversewing has been proposed as a cost-effective and helpful method for reinforcing the staple line. Aim of the study: To evaluate the benefit of staple lines over sewing in decreasing postoperative complications and their severity. Patients and methods: One hundred laparoscopic surgery group (LSG) patients were randomly assigned to either group (A) without staple line over sewing or (B) with staple line over sewing from January 2022 to January 2023 in a prospective study conducted at three hospitals (Alhussein Medical City, Alkafeel Private Hospital, and Zain Alabdin Private Hospital). We want to learn if laparoscopic sleeve gastrectomy patients benefited more from a staple line than a sewn one. Results: The most frequently reported complication was bleeding, which was reported in two patients in group A and one patient in group B, respectively; vomiting was reported more frequently in group B. The cross-tabulation between complications and comorbidities revealed no significant association between them. The hospital stay was the same in both groups except for patients with non-surgical complications, which need more hospital stay time. In regard to the severity of complications, we found that complicated cases in group A needed more hospital stays and more interventions to control the problem in comparison to those in group B. Conclusion: Laparoscopic sleeve gastrectomy with staple line over sewing is a technique that may decrease early complications and the severity of complications. There was no significant difference between the two groups (with and without staple line over sewing) in regard to the relation between complications on one side and the comorbidity on the other.