Sergio Susmallian1, David Goitein2, Royi Barnea3, Asnat Raziel4. 1. Department of General Surgery, Assuta Health Services Research Institute Assuta Medical Center, Tel Aviv, Israel. 2. Department of Surgery C, Sheba Medical Center, Tel Hashomer, affiliated with Sackler School of Medicine, Tel Aviv University, Tel Aviv, Israel. 3. Assuta Health Services Research Institute Assuta Medical Center, Tel Aviv, Israel. 4. Assia Medical Group, Assuta Health Services Research Institute Assuta Medical Center, Tel Aviv, Israel.
Abstract
BACKGROUND: Leakage from the staple line is the most serious complication encountered after sleeve gastrectomy, occurring in 2.4% of surgeries. The use of inappropriately sized staplers, because of variability in stomach wall thickness, is a major cause of leakage. OBJECTIVES: To measure stomach wall thickness across different stomach zones to identify variables correlating with thickness. METHODS: The study comprised 100 patients (52 females). Stomach wall thickness was measured immediately after surgery using a digital caliper at the antrum, body, and fundus. Results were correlated with body mass index (BMI), age, gender, and pre-surgical diagnosis of diabetes, hypertension, hyperlipidemia and fatty liver. RESULTS: Stomach thickness was found to be 5.1 ± 0.6 mm at the antrum, 4.1 ± 0.6 mm at the body, and 2. 6 ± 0.5 mm at the fundus. No correlation was found between stomach wall thickness and BMI, gender, or co-morbidities. CONCLUSIONS: Stomach wall thickness increases gradually from the fundus toward the antrum. Application of the correct staple height during sleeve gastrectomy is important and may, theoretically, prevent leaks. Staplers should be chosen according to the thickness of the tissue.
BACKGROUND: Leakage from the staple line is the most serious complication encountered after sleeve gastrectomy, occurring in 2.4% of surgeries. The use of inappropriately sized staplers, because of variability in stomach wall thickness, is a major cause of leakage. OBJECTIVES: To measure stomach wall thickness across different stomach zones to identify variables correlating with thickness. METHODS: The study comprised 100 patients (52 females). Stomach wall thickness was measured immediately after surgery using a digital caliper at the antrum, body, and fundus. Results were correlated with body mass index (BMI), age, gender, and pre-surgical diagnosis of diabetes, hypertension, hyperlipidemia and fatty liver. RESULTS: Stomach thickness was found to be 5.1 ± 0.6 mm at the antrum, 4.1 ± 0.6 mm at the body, and 2. 6 ± 0.5 mm at the fundus. No correlation was found between stomach wall thickness and BMI, gender, or co-morbidities. CONCLUSIONS: Stomach wall thickness increases gradually from the fundus toward the antrum. Application of the correct staple height during sleeve gastrectomy is important and may, theoretically, prevent leaks. Staplers should be chosen according to the thickness of the tissue.
Authors: Maciej Patrzyk; Jenny Sonke; Anne Glitsch; Rebecca Kessler; Antje Steveling; Sebastian Lünse; Lars Ivo Partecke; Claus-Dieter Heidecke; Wolfram Kessler Journal: Visc Med Date: 2021-02-17
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Authors: Anıl Ergin; Hüseyin Çiyiltepe; Aziz Bora Karip; Mehmet Mahir Fersahoğlu; Nuriye Esen Bulut; Ahmet Çakmak; Berk Topaloğlu; Ali Cihan Bilgili; Adnan Somay; İksan Taşdelen; Ümit Akyüz; Kemal Memişoğlu Journal: Obes Surg Date: 2021-06-01 Impact factor: 4.129