Stapling technology with triple-row and enhanced staple configurations evaluated in a series of 124 consecutive laparoscopic vertical gastrectomies


  • Alessandro Bianchi Department of General Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
  • Alberto Pagan-Pomar Department of General Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
  • Marina Jimenez-Segovia Department of General Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
  • Carla Soldevila-Verdeguer Department of General Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
  • Jaume Bonnin-Pascual Department of General Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
  • José Antonio Martinez-Corcoles Department of General Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain
  • Xavier Francesc González-Argenté Department of General Surgery, Hospital Universitario Son Espases, Palma de Mallorca, Spain



Sleeve gastrectomy, Stapler, Staple lines, Staple line bleed, Staple line leak, Staple line oversewing


Background: Laparoscopic sleeve gastrectomy (LSG) is a procedure frequently used to treat morbid obesity, due to its simplicity compared to other bariatric techniques. However, LSG can lead to serious complications, such as gastric leakage and bleeding from the staple line. To reduce these complications, seroserosal reinforcement of the mechanical suture line after gastrectomy is generally recommended. In recent decades, studies have focused on the safety of anastomosis with staples, especially compared to manual sewing techniques. Since studies on the improvement of stapling technology are limited, this study arises to compare the clinical results of staple line oversewing versus stapling technology with triple-row and enhanced staple configurations in laparoscopic sleeve gastrectomy.

Methods: A retrospective review from a prospectively maintained database of 124 laparoscopic vertical gastrectomies performed at single centre between March 2010 and December 2016. Patients were divided into two groups, with comparable anthropometric parameters and inclusion criteria. Seroserosal reinforcement was used in the first group, and stapling technology with triple-row and enhanced staple configurations in the second. Rates of anastomotic leakage, bleeding, reoperation, and 30-day mortality were compared.

Results: In Group 1 the average surgical time was 125 min, whereas in Group 2 it was 87 min. No differences were found between the two groups regarding leakage or bleeding of the staple line.

Conclusions: The use of triple-row stapling devices during laparoscopic vertical gastrectomy enables surgical time to be reduced. Further high-quality studies to evaluate the efficacy and effectiveness of stapling technology with triple-row and enhanced staple configurations are needed.


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