Evaluation of different stapler line strengthening techniques with burst pressures in patients undergoing sleeve gastrectomy. An experimental study.

AIM Obesity is a leading cause of preventable death worldwide and is increasing in both adults and children. Bariatric surgery is the most effective treatment for this condition and its related comorbidities. We aimed to evaluate the effectiveness of different staple line reinforcement techniques on staple line reinforcement through bursting pressures. METHODS Different stapler line strengthening techniques were performed on resected stomach patterns of 48 patients. The patients were enrolled prospectively into 4 groups according to surgeons preferred type of staple line reinforcement. Data concerning patient demographic variables, surgical parameters, postoperative complications, postoperative readmissions, burst pressure and burst point were collected. None of the obese patients were excluded from this study. RESULTS There were no statistically significant differences in the characteristics of the groups. The number of staple cartridges fired and the linearity of the staple line were similar in all groups, (p 0.524-0.265). However, there were significant differences in the burst pressure measurements in groups I, II, IIIand IV (p .001). In all groups, the burst point on the staple line of resected stomach was most commonly in the fundus section. CONCLUSIONS We believe that the burst pressure in Fibrin sealant group is significantly higher and that fibrin glue can be effective in preventing stapler line leakage. We believe that more advanced studies are needed. KEY WORDS Fibrin Sealant, Leakage, Reinforcement.