title: Comparison of four different methods in staple line reinforcement during laparascopic sleeve gastrectomy.
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.
authors.affiliation: Department of General Surgery, Antalya Training and Research Hospital Antalya, Turkey.
authors.forename: Nurullah
authors.initials: N
authors.lastname: Bülbüller
authors.forename: Arif
authors.initials: A
authors.lastname: Aslaner
authors.forename: Osman Zekai
authors.initials: OZ
authors.lastname: Oner
authors.forename: Mehmet Tahir
authors.initials: MT
authors.lastname: Oruç
authors.forename: Umit
authors.initials: U
authors.lastname: Koç
authors.forename: Nuray Ayper
authors.initials: NA
authors.lastname: Ongen
authors.forename: Ramazan
authors.initials: R
authors.lastname: Eryılmaz
authors.forename: Güvenç
authors.initials: G
authors.lastname: Cantilav
authors.forename: Mani
authors.initials: M
authors.lastname: Habibi
authors.forename: Sükrü
authors.initials: S
authors.lastname: Ozdemir
keywords: Laparascopic Sleeve Gastrectomy (LSG); reinforcement; suture; tisseel; v-loc