title: Laparoscopic sleeve gastrectomy with endoscopic versus bougie calibration: results of a prospective study.
abstract: BACKGROUND
  The use of the endoscope for the calibration of the gastric sleeve, instead of the standard use of the bougie, is a safe procedure and gives the surgeon a higher sense of security. The aim of this study was to evaluate the effect of the use of endoscopic guidance on postoperative complications and mid-term results of the bariatric procedure.
  
  
  METHODS
  A prospective, nonrandomized study was performed at the General University Hospital of Elche (Alicante, Spain) between 2010 and 2013. The patients were divided into the bougie calibration group and the endoscopic calibration group. The decision of which method to use depended on the availability of an endoscopist at the time of the surgery.
  
  
  RESULTS
  Fifty patients were included in the study, 44 females (88%) and 6 males (12%), with a mean age of 43.3 years and a preoperative mean body mass index of 50.6 kg/m(2). In the endoscopic calibration group, a bleeding point in the staple line was detected and sclerosed with adrenaline in 1 patient. In the bougie calibration group there were no cases of postoperative digestive bleeding. The intraoperative tightness check with blue dye and air insufflation through an orogastric tube in the bougie calibration group was negative in all the patients. In the endoscopic calibration group the check with blue dye was also negative in all cases, but the second test with air detected the exit of air bubbles in 1 case. There were no significant differences in the operation time between groups. A significant reduction in the major complications rate was observed in the endoscopic calibration group (odds ratio=0.9; P=.034).
  
  
  CONCLUSIONS
  Endoscopic calibration is associated with lower postoperative complications after laparoscopic sleeve gastrectomy.
authors.affiliation: 1 Department of Surgery, General University Hospital Elche , Alicante, Spain .
authors.forename: Jaime
authors.initials: J
authors.lastname: Ruiz-Tovar
authors.forename: Javier
authors.initials: J
authors.lastname: Sola-Vera
authors.forename: Elena
authors.initials: E
authors.lastname: Miranda
authors.forename: José Luis
authors.initials: JL
authors.lastname: Muñoz
authors.forename: Estefania
authors.initials: E
authors.lastname: Perez-Rabasco
authors.forename: Antonio
authors.initials: A
authors.lastname: Arroyo
authors.forename: Rafael
authors.initials: R
authors.lastname: Calpena
mesh_terms: D000328:Adult; D015992:Body Mass Index; D002138:Calibration; D005260:Female; D005743:Gastrectomy / Q000295:instrumentation / Q000379:methods*; D005773:Gastroscopy / Q000295:instrumentation / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000601:surgery; D061646:Operative Time; D011183:Postoperative Complications / Q000517:prevention & control; D019106:Postoperative Hemorrhage / Q000517:prevention & control; D011446:Prospective Studies; D017792:Surgical Stapling; D015431:Weight Loss