Laparoscopic Sleeve Gastrectomy with T-Shaped Omentoplasty: Impact on the Early Postoperative Outcomes
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Laparoscopic Sleeve Gastrectomy with T-Shaped Omentoplasty: Impact on the Early Postoperative Outcomes Emad Abdallah 1 & Mahmoud Zakaria 2 & Mohamed Fikry 1 & Mahmoud Abdelnaby 1 & Waleed Gado 1 & Samy Abbas Elbaz 1 & Sabry Ahmed Mahmoud 1 & Sameh Hany Emile 1 Received: 17 January 2020 / Revised: 22 May 2020 / Accepted: 28 May 2020 # Springer Science+Business Media, LLC, part of Springer Nature 2020
Abstract Purpose Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric procedure, yet can be followed by complications such as staple line leak and bleeding, vomiting, and gastroesophageal reflux disease (GERD). Various attempts have been described in the literature to improve the early outcome of LSG through various measures. This study aimed to assess the impact of adding Tshaped omentoplasty to LSG on the short-term outcome of the procedure. Methods This was a retrospective cohort study on patients with morbid obesity who underwent LSG in the period of November 2015 to November 2018. The outcome of patients with morbid obesity who underwent LSG combined with T-shaped omentoplasty (group I) was compared with that of a similar number of patients who underwent classical LSG without staple line fixation (group II). The main outcome measures were the rates of staple line bleeding and leak, postoperative nausea and vomiting (PONV), GERD, gastric axial rotation, other complications, and weight loss. Results The study included 106 patients of a mean BMI of 49.8 kg/m2. Group II had significantly higher PONV) scale at 1 week and 1 month than group I. Group I had significantly lower rates of staple line bleeding (0 vs 9.6%, p = 0.02) and GERD (3.7% vs 17.3%, p = 0.02) than group II. Both groups had similar rates of staple line leak and comparable operation time. Conclusion Staple line fixation using the T-shaped omentoplasty technique was associated with lower incidence of significant PONV, staple line bleeding, and GERD as compared with classical LSG. Keywords Sleeve gastrectomy . Staple line fixation . T-shaped . Omentoplasty . Short-term
Introduction Laparoscopic sleeve gastrectomy (LSG) has become one of the most popular bariatric procedures [1]. In addition to the satisfactory weight loss induced by LSG, the procedure also tends to induce improvement in several obesity-related comorbidities. However, some potentially serious complications
of LSG have been reported, including staple line bleeding and leak [2]. According to a recent literature review, the average rates of staple line bleeding and leak are about 2% and 2.2–2.4%, respectively [3]. Several attempts have been made to minimize the incidence of staple line complications. Sleeve fixation is a novel technique proposed by Godoy and Coleho [4] to reduce
* Sameh Hany Emile [email protected]
Waleed Gado [email protected]
Emad Abdallah [email protected]
Samy Abbas Elbaz [email protected]
Mahmoud Zakaria [email protected]
Sabry Ahmed Mahmoud [email protected]
Mohamed Fikry [email protected]
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