title: Stapleless laparoscopic sleeve gastrectomy. Preliminary report.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (SG) as a single-stage procedure for the treatment of morbid obesity is becoming increasingly popular. In undeveloped countries, the linear staples required to create the sleeve are not always available because of their high cost. As an alternative to the staples, the bipolar vessel sealer device could be used in bariatric surgery to divide and temporarily seal the stomach.
  
  
  METHODS
  Universidad Central de Venezuela, Caracas, Venezuela.
  
  
  METHODS
  Between May 2015 and July 2016, 9 patients with a mean body mass index of 38.2 kg/m2were submitted to a stapleless laparoscopic SG using the bipolar vessel sealer for the gastric division. The sleeve was performed over a 42 French bougie and closed with 2 layers of running sutures. Surgical time, morbidity, hospital stay, and excess weight loss were prospectively collected.
  
  
  RESULTS
  Mean operative time and hospital stay were 117 min and 2.3 days. There was no major morbidity but 2 patients presented a basal atelectasis, which was solved by medical treatment without consequences. After a mean follow up of 6.8 months the mean excess weight loss was 78.4%.
  
  
  CONCLUSIONS
  The technique of stapleless laparoscopic SG presented in this report is a valid alternative when these devices are not available. Large series with long-term follow-up are necessary to make definitive conclusions.
authors.affiliation: Universidad Central de Venezuela, Caracas, Venezuela. Electronic address: jlleyba@yahoo.es.
authors.forename: Jose Luis
authors.initials: JL
authors.lastname: Leyba
authors.affiliation: Clínica Santa Sofía, Caracas, Venezuela.
authors.forename: Salvador Navarrete
authors.initials: SN
authors.lastname: Llopis
authors.affiliation: Universidad Central de Venezuela, Caracas, Venezuela.
authors.forename: Salvador Navarrete
authors.initials: SN
authors.lastname: Aulestia
authors.affiliation: Clínica Santa Sofía, Caracas, Venezuela.
authors.forename: Ricardo
authors.initials: R
authors.lastname: Ochoa
authors.affiliation: Clínica Santa Sofía, Caracas, Venezuela.
authors.forename: Eliana
authors.initials: E
authors.lastname: Azuaje
mesh_terms: D000328:Adult; D015992:Body Mass Index; D005260:Female; D005500:Follow-Up Studies; D005743:Gastrectomy / Q000379:methods*; D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D008297:Male; D008875:Middle Aged; D009767:Obesity, Morbid / Q000503:physiopathology / Q000601:surgery*; D012189:Retrospective Studies; D017792:Surgical Stapling / Q000379:methods*; D013997:Time Factors; D016896:Treatment Outcome; D015431:Weight Loss
keywords: Laparoscopic sleeve gastrectomy; bipolar sealer; stapleless