 | |  | |  | |  | |  | |  | |  | |  |
| IJCEM Copyright © 2008-All rights reserved. Published by e-Century Publishing Corporation, Madison, WI 53711 |
Int J Clin Exp Med 2013;6(10):985-990
Original Article
Comparison of four different methods in staple line reinforcement during
laparascopic sleeve gastrectomy
Nurullah Bülbüller, Arif Aslaner, Osman Zekai Öner, Mehmet Tahir Oruç, Ümit Koç, Nuray Ayper Öngen, Ramazan Eryılmaz, Güvenç
Cantilav, Mani Habibi, Şükrü Özdemir
Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey; Department of General Surgery, Antalya
University Medical Faculty, Antalya, Turkey
Received August 30, 2013; Accepted October 17, 2013; Epub October 25, 2013; Published October 30, 2013
Abstract: The main early complications of Laparascopic Sleeve Gastrectomy are bleeding and gastric leakage. Many reinforcement
methods are performed in order to reduce these complications. In this prospective, randomized study, we compared four different
techniques to evaluate staple line reinforcement in Laparascopic Sleeve Gastrectomy. Between January 2012 and May 2013, 65
patients were prospectively randomized into four groups in which different techniques were used in handling the staple line during
Laparascopic Sleeve Gastrectomy. Of the four groups, there wasn’t any reinforcement used on 15 patients during LSG (group 1),
continuous serosal 3-0 prolene sutures were used on 16 patients for staple line reinforcement (group 2), staple line was supported
with v-loc suture in 16 patients (group 3), and 18 patients had Tisseel fibrin sealant applied throughout the staple line (group 4). 40 of
65 patients were females, the mean age was 36.8 years (20-58 years), and the mean BMI was 49.2 (41-60 kg/m²). Characteristics of
patients among groups were similar. There wasn’t any significant difference found between groups for BMI. Gastric leakage was
detected from the staple line in 2 patients of the v-loc group. According to our results, we demonstrated that good results can be
obtained without any reinforcement. Reinforcement with propylene suture only prolongs the operation time, and tissue fibrin sealent
increases the cost. In conclusion, we should be more careful using v-loc sutures, and further series with larger numbers are needed to
test v-loc. (IJCEM1308021).
Keywords: Laparascopic Sleeve Gastrectomy (LSG), reinforcement, v-loc, tisseel, suture
Address correspondence to: Dr. Nurullah Bülbüller, Genel Cerrahi Kliniği, Antalya Eğitim ve Araştırma Hastanesi, Varlık Mahallesi,
Kazım Karabekir Caddesi Soğuksu PO Box 07100, Antalya, Türkiye. Tel: +902422494400, 4480; +905324153749; Fax:
+902422494462; E-mail: nbulbuller@yahoo.com
Original Article
Comparison of four different methods in staple line reinforcement during
laparascopic sleeve gastrectomy
Nurullah Bülbüller, Arif Aslaner, Osman Zekai Öner, Mehmet Tahir Oruç, Ümit Koç, Nuray Ayper Öngen, Ramazan Eryılmaz, Güvenç
Cantilav, Mani Habibi, Şükrü Özdemir
Department of General Surgery, Antalya Training and Research Hospital, Antalya, Turkey; Department of General Surgery, Antalya
University Medical Faculty, Antalya, Turkey
Received August 30, 2013; Accepted October 17, 2013; Epub October 25, 2013; Published October 30, 2013
Abstract: The main early complications of Laparascopic Sleeve Gastrectomy are bleeding and gastric leakage. Many reinforcement
methods are performed in order to reduce these complications. In this prospective, randomized study, we compared four different
techniques to evaluate staple line reinforcement in Laparascopic Sleeve Gastrectomy. Between January 2012 and May 2013, 65
patients were prospectively randomized into four groups in which different techniques were used in handling the staple line during
Laparascopic Sleeve Gastrectomy. Of the four groups, there wasn’t any reinforcement used on 15 patients during LSG (group 1),
continuous serosal 3-0 prolene sutures were used on 16 patients for staple line reinforcement (group 2), staple line was supported
with v-loc suture in 16 patients (group 3), and 18 patients had Tisseel fibrin sealant applied throughout the staple line (group 4). 40 of
65 patients were females, the mean age was 36.8 years (20-58 years), and the mean BMI was 49.2 (41-60 kg/m²). Characteristics of
patients among groups were similar. There wasn’t any significant difference found between groups for BMI. Gastric leakage was
detected from the staple line in 2 patients of the v-loc group. According to our results, we demonstrated that good results can be
obtained without any reinforcement. Reinforcement with propylene suture only prolongs the operation time, and tissue fibrin sealent
increases the cost. In conclusion, we should be more careful using v-loc sutures, and further series with larger numbers are needed to
test v-loc. (IJCEM1308021).
Keywords: Laparascopic Sleeve Gastrectomy (LSG), reinforcement, v-loc, tisseel, suture
Address correspondence to: Dr. Nurullah Bülbüller, Genel Cerrahi Kliniği, Antalya Eğitim ve Araştırma Hastanesi, Varlık Mahallesi,
Kazım Karabekir Caddesi Soğuksu PO Box 07100, Antalya, Türkiye. Tel: +902422494400, 4480; +905324153749; Fax:
+902422494462; E-mail: nbulbuller@yahoo.com
