Laparoscopic Sleeve Gastrectomy and the “Sydney Patch”: Triple Reinforcement of Staple Line: A Study with 546 Patients

Abstract

Background:

Laparoscopic sleeve gastrectomy (LSG) is the most common surgical procedure for treating obese patients. The most common complications from this procedure include postoperative staple line leaks and postoperative bleeding. The aim of this study is to investigate the impact of an innovative approach, known as the “Sydney Patch” (SP). This approach was developed in 2016 at our institution as a new technique to reduce complications.

Methods:

This retrospective study analyzed 546 patients' data who underwent a primary LSG with and without SP between January 2014 and August 2017. All data analyses were performed using SPSS 22.0. In both groups, we considered demographics and comorbidities at baseline. Continuous variables are expressed as mean ± standard deviation and categorical variables were reported as number (percent). Continuous variables were analyzed by means of the independent samples t-test and categorical variables were compared using the χ² test. A p-value of <0.05 was defined as being statistically significant.

Results:

A total of 462 patients had SP, whereas 84 patients had LSG without SP. There was no significant difference between the two groups concerning age, gender distribution, and preoperative weight and body mass index. In addition, the rate of comorbidities was similar in both groups. There was a significant association between the use of SP and whether or not patient developed gastric leaks (χ² [1, n = 456] = 27.75, p < 0.001). Patients who had SP were less likely to develop gastric leaks (0% in our study) than those who had LSG without the SP.

Conclusion:

This study shows promising results for the reduction of staple line leaks after LSG. We believe that the SP technique offers an extra reinforcement to the vulnerable upper gastric staple line and that it may reduce staple line leak rates after LSG and also be a cost-effective and efficient method, comparing with synthetic staple line reinforcement.