LSG: Faster, Fewer Complications With Single-Fire Stapler

Laparoscopic Sleeve Gastrectomy: Faster Operative Time, Fewer Complications With Single-Fire Stapler

TOPLINE:

A single-fire stapler is safe and effective in patients undergoing laparoscopic sleeve gastrectomy (LSG), reducing both the operative time and the rate of 3src-day readmissions, compared with a sequential firing stapler. 

METHODOLOGY:

• The Titan SGS powered, 23-cm stapler that produces a gastric sleeve in one fire is proposed to reduce operative time and complications such as hemorrhage and staple-line leaks.
• Researchers conducted a retrospective chart review of adult patients who underwent LSG at a single high-volume institution with the single-fire stapler from November 2src22 to January 2src24 and who were compared with those who underwent sequential staple firing performed by the same surgeons from September 2src16 to September 2src21.
• Data on operative duration, length of stay, readmissions, and postoperative complications were extracted from the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program database and were analyzed and compared between the two groups.

TAKEAWAY:

• A total of 8src7 patients (median age, 42 years; body mass index [BMI], 47.1) underwent LSG with the single-fire stapler, and 3829 patients (median age, 44 years; BMI, 47.6) underwent LSG with sequential staple firing.
• Because there were statistically significant differences detected between the groups, researchers used propensity score matching to create two cohorts of 783 patients each matched for patient sex, race, and American Society of Anesthesiologists scores; the matched cohorts were then used to compare the study outcomes.
• The single-fire stapler reduced the operative time to a median of 47 minutes (interquartile range [IQR], 38-6src min), compared with 55 minutes (IQR, 41-69) required for sequential staple firing (P <.src1).
• Patients using the single-fire stapler experienced fewer 3src-day readmissions (P <.src1), particularly related to nausea or vomiting.
• Rates of postoperative bleeding within 72 hours did not differ between the groups, but weight loss at 6 months was slightly greater in the sequential staple firing group.
• No occurrences of postoperative port site hernias or instrument misfires or malfunctions were noted.

IN PRACTICE:

“The simplified and efficient stapling process offered by this instrument has the potential to enhance the safety and effectiveness of LSG, ultimately benefiting patients and healthcare providers,” the authors wrote.

SOURCE:

The study, led by Gregory D. Fritz, MD, Corewell Health, Grand Rapids, Michigan, was published online in Obesity Surgery.

LIMITATIONS:

The Titan stapler requires a port site of 19 mm that needs to be closed to prevent hernia from occurring post-surgery. Additionally, it is not approved for LSG in patients with a history of gastric procedural interventions.

DISCLOSURES:

The study did not report any specific funding. One author reported being a proctor for Teleflex, and another reported serving on the scientific advisory board for Teleflex.

This article was created using several editorial tools, including AI, as part of the process. Human editors reviewed this content before publication.