Skip to main content
Top
Published in: Obesity Surgery 10/2020

01-10-2020 | Omentoplasty | Original Contributions

Laparoscopic Sleeve Gastrectomy with T-Shaped Omentoplasty: Impact on the Early Postoperative Outcomes

Authors: Emad Abdallah, Mahmoud Zakaria, Mohamed Fikry, Mahmoud Abdelnaby, Waleed Gado, Samy Abbas Elbaz, Sabry Ahmed Mahmoud, Sameh Hany Emile

Published in: Obesity Surgery | Issue 10/2020

Login to get access

Abstract

Purpose

Laparoscopic sleeve gastrectomy (LSG) is an effective bariatric procedure, yet can be followed by complications such as staple line leak and bleeding, vomiting, and gastroesophageal reflux disease (GERD). Various attempts have been described in the literature to improve the early outcome of LSG through various measures. This study aimed to assess the impact of adding T-shaped omentoplasty to LSG on the short-term outcome of the procedure.

Methods

This was a retrospective cohort study on patients with morbid obesity who underwent LSG in the period of November 2015 to November 2018. The outcome of patients with morbid obesity who underwent LSG combined with T-shaped omentoplasty (group I) was compared with that of a similar number of patients who underwent classical LSG without staple line fixation (group II). The main outcome measures were the rates of staple line bleeding and leak, postoperative nausea and vomiting (PONV), GERD, gastric axial rotation, other complications, and weight loss.

Results

The study included 106 patients of a mean BMI of 49.8 kg/m2. Group II had significantly higher PONV) scale at 1 week and 1 month than group I. Group I had significantly lower rates of staple line bleeding (0 vs 9.6%, p = 0.02) and GERD (3.7% vs 17.3%, p = 0.02) than group II. Both groups had similar rates of staple line leak and comparable operation time.

Conclusion

Staple line fixation using the T-shaped omentoplasty technique was associated with lower incidence of significant PONV, staple line bleeding, and GERD as compared with classical LSG.
Literature
4.
go back to reference Godoy E, Coelho D. Gastric sleeve fixation strategy in laparoscopic vertical sleeve gastrectomy. ABCD Arq Bras Cir Dig. 2013;26(Suplemento 1):79–82.CrossRef Godoy E, Coelho D. Gastric sleeve fixation strategy in laparoscopic vertical sleeve gastrectomy. ABCD Arq Bras Cir Dig. 2013;26(Suplemento 1):79–82.CrossRef
5.
go back to reference Abdallah E, Emile SH, Elfeki H. Laparoscopic sleeve gastrectomy with or without staple line inversion and distal fixation to the transverse mesocolon: impact on early postoperative outcomes. Obes Surg. 2017;27(2):323–9.CrossRef Abdallah E, Emile SH, Elfeki H. Laparoscopic sleeve gastrectomy with or without staple line inversion and distal fixation to the transverse mesocolon: impact on early postoperative outcomes. Obes Surg. 2017;27(2):323–9.CrossRef
6.
go back to reference Myles PS, Wengritzky R. Simplified postoperative nausea and vomiting impact scale for audit and post-discharge review. Br J Anaesth. 2012;108(3):423–9.CrossRef Myles PS, Wengritzky R. Simplified postoperative nausea and vomiting impact scale for audit and post-discharge review. Br J Anaesth. 2012;108(3):423–9.CrossRef
7.
go back to reference Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587–606.CrossRef Brethauer SA, Kim J, El Chaar M, et al. Standardized outcomes reporting in metabolic and bariatric surgery. Obes Surg. 2015;25(4):587–606.CrossRef
9.
go back to reference Elbalshy MA, Fayed AM, Abdelshahid MA, et al. Role of staple line fixation during laparoscopic sleeve gastrectomy. Int Surg J. 2018;5:156–61.CrossRef Elbalshy MA, Fayed AM, Abdelshahid MA, et al. Role of staple line fixation during laparoscopic sleeve gastrectomy. Int Surg J. 2018;5:156–61.CrossRef
10.
go back to reference Santoro S. Technical aspects in sleeve gastrectomy. Obes Surg. 2007;17(11):1534–5.CrossRef Santoro S. Technical aspects in sleeve gastrectomy. Obes Surg. 2007;17(11):1534–5.CrossRef
11.
go back to reference Fallatah B, Shehry A, Abdelsamad L, et al. Comparison study of gastric emptying after performing sleeve gastrectomy with two different techniques. Glob J Surg. 2013;1(4):53–6. Fallatah B, Shehry A, Abdelsamad L, et al. Comparison study of gastric emptying after performing sleeve gastrectomy with two different techniques. Glob J Surg. 2013;1(4):53–6.
12.
go back to reference Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19(11):1515–21.CrossRef Braghetto I, Davanzo C, Korn O, et al. Scintigraphic evaluation of gastric emptying in obese patients submitted to sleeve gastrectomy compared to normal subjects. Obes Surg. 2009;19(11):1515–21.CrossRef
13.
go back to reference Sista F, Abruzzese V, Clementi M, et al. The effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study. Surg Obes Relat Dis. 2017;13(1):7–14.CrossRef Sista F, Abruzzese V, Clementi M, et al. The effect of sleeve gastrectomy on GLP-1 secretion and gastric emptying: a prospective study. Surg Obes Relat Dis. 2017;13(1):7–14.CrossRef
14.
go back to reference Vives M, Molina A, Danús M, et al. Analysis of gastric physiology after laparoscopic sleeve gastrectomy (LSG) with or without antral preservation in relation to metabolic response: a randomised study. Obes Surg. 2017;27:2836–44.CrossRef Vives M, Molina A, Danús M, et al. Analysis of gastric physiology after laparoscopic sleeve gastrectomy (LSG) with or without antral preservation in relation to metabolic response: a randomised study. Obes Surg. 2017;27:2836–44.CrossRef
15.
go back to reference Emile SH. Gastroesophageal reflux disease after sleeve gastrectomy: the need to predict its onset and prevent its consequences. Obes Surg. 2019 Aug;29(8):2625–6.CrossRef Emile SH. Gastroesophageal reflux disease after sleeve gastrectomy: the need to predict its onset and prevent its consequences. Obes Surg. 2019 Aug;29(8):2625–6.CrossRef
16.
go back to reference Baumann T, Kuesters S, Grueneberger J, et al. Time-resolved MRI after ingestion of liquids reveals motility changes after laparoscopic sleeve gastrectomy--preliminary results. Obes Surg. 2011;21(1):95–101.CrossRef Baumann T, Kuesters S, Grueneberger J, et al. Time-resolved MRI after ingestion of liquids reveals motility changes after laparoscopic sleeve gastrectomy--preliminary results. Obes Surg. 2011;21(1):95–101.CrossRef
Metadata
Title
Laparoscopic Sleeve Gastrectomy with T-Shaped Omentoplasty: Impact on the Early Postoperative Outcomes
Authors
Emad Abdallah
Mahmoud Zakaria
Mohamed Fikry
Mahmoud Abdelnaby
Waleed Gado
Samy Abbas Elbaz
Sabry Ahmed Mahmoud
Sameh Hany Emile
Publication date
01-10-2020
Publisher
Springer US
Published in
Obesity Surgery / Issue 10/2020
Print ISSN: 0960-8923
Electronic ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-020-04743-6

Other articles of this Issue 10/2020

Obesity Surgery 10/2020 Go to the issue