TITLE:
Gastroenteroanastomosis Techniques for Laparoscopic Gastric Bypass: Linear vs Circular Stapler
AUTHORS:
Matheus Netto, Augusto Tinoco, Igor Fonte Bôa, Ivana Duval-Araújo
KEYWORDS:
Gastric Bypass, Roux-en-Y, Obesity, Bariatric Surgery, Surgical Stapling, Postoperative Complications
JOURNAL NAME:
Surgical Science,
Vol.14 No.7,
July
20,
2023
ABSTRACT: Background: Laparoscopic Roux-en-Y gastric bypass (LRYGB) is an
effective and well-accepted procedure for the
treatment of morbid obesity but has complications such as stenosis of
the gastroenteroanastomosis (GE), GE leak, surgical site infection, and
stapling malfunction. This study evaluated the efficiency of weight loss and the incidence of short- and mid-term
postoperative complications in patients undergoing LRYGB in which
anastomosis was performed using a
linear stapler (LSA) or a circular stapler (CSA). Methods: Prospective
observational study conducted between April 2016 and March 2019. The data were
extracted from a hospital database that includes patients undergoing LRYGB in
two different GE techniques, assessing postoperative complications and
excess body weight loss. Results: Data from 457 patients were analyzed, of which 216 were in the LSA group
and 241 were in the CSA group. There were four cases (1.7%) of GE stenosis in
the CSA group and only one (0.5%) in the LSA group. Stapler malfunction
occurred in both groups: CSA (0.4%) and LSA (0.5%), and a GE leak developed
only in the CSA group (0.4%). Surgical site
infection was found in five patients in the CSA group (2.1%) and two in the LSA
group (0.9%). No statistical difference was found between the two groups in any
of the variables analyzed (p > 0.05). Conclusions: Both stapling techniques resulted in a similar loss of
excess body weight during the follow-up period. Although the LSA group had
fewer total complications, these were not statistically significant, which
substantiates the fact that both techniques are safe and feasible, provided
they are performed by a surgeon with a long learning curve
in laparoscopic bariatric surgery.