Staple Line Reinforcement in Laparoscopic Sleeve Gastrectomy; Randomized Comparative Study

Introduction: The most common bariatric surgery in the world nowadays is laparoscopic sleeve gastrectomy(LSG). Surgeons performing LSG use Staple Line Reinforcement (SLR) to decrease the rate of complications likestaple line bleeding and leakage. Researchers have looked into SLR and found that it can help prevent thesecomplications. The aim of this work was to study the outcome of SLR in LSG on postoperative complications.Aim of work: The aim of this study was to look at how SLR in LSG affected primary surgical complications likebleeding, gastric outlet obstruction leading to vomiting and leakage. And study secondary outcomes like losingweight.Patients and methods: This randomized controlled comparative study was carried out on 345 patients aged from18 to 60 years old of both sexes, seeking LSG with BMI > 35 and <50 kg/m2. Patients were randomly allocated intothree groups (115 in each): group I subjected to no reinforcement, group II subjected to bioabsorbable buttressreinforcement, and group III subjected to overrunning suture.Results: Regarding bleeding incidence, there was a statistically significant lower rate of bleeding in the overrunningsuture and bioabsorbable buttress reinforcement than no reinforcement group, as bleeding developed in 10.4% ofgroup I, 3.5% in group II develop, and 1.7% in group III. No differences were noted between different types ofinterventions regarding differences in BMI, leakage rate and sleeve obstruction leading to vomiting.Conclusion: SLR as bioabsorbable buttress reinforcement or overrunning suture does not seem to reduce the riskof leak, or sleeve obstruction or the overall complication rates compared to traditional sleeve gastrectomy withoutreinforcement except for bleeding which was significantly lower with reinforcement interventions.