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Comparison of permanent and nonpermanent staple line buttressing materials for linear gastric staple lines during laparoscopic Roux-en-Y gastric bypass.
Surg Obes Relat Dis. 2008 Nov-Dec; 4(6):729-34.SO

Abstract

BACKGROUND

Several publications have suggested that staple line buttressing might decrease staple line bleeding, increase burst pressure, and decrease the likelihood of acute failure resulting in leak. Currently, permanent and nonpermanent options are available. However, concern has been raised about the permanent buttress material and its potential for delayed strip expulsion. This study analyzed our experience with 3 different buttressing materials for creating the gastric division during laparoscopic Roux-en-Y gastric bypass.

METHODS

From July 5, 2001 to May 30, 2007, 1451 consecutive patients underwent laparoscopic gastric bypass with buttressing material used for the stapled creation of the gastric pouch. Peristrips Dry (PSDs), permanent bovine pericardial strips, were used in 926 cases from July 5, 2001 to October 11, 2005. Seamguards, a synthetic bioabsorbable product, were used in 145 cases from November 2, 2004 to July 18, 2006, and PSD Veritas, remodelable, nonpermanent bovine pericardial strips, were placed in 380 patients from October 11, 2005 to May 30, 2007. All products were applied to the 60-mm-long, 3.5-mm cartridges of the EndoGIA II stapler. The ease of use, operative complications, visual bleeding, and postoperative leaks were recorded.

RESULTS

The patient characteristics were comparable for all groups. All products were easy to load on the stapler, and no operative complications related to the use of the buttress materials occurred. The incidence and severity of staple line bleeding was not specifically calculated but was visually noted to be minimal in all cases. Of the 3 groups, 4 contained leaks occurred in the Seamguards group, and all were successfully managed nonoperatively. No acute leaks were discovered in the PSD or PSD Veritas groups. This difference was statistically significant (p <.001).

CONCLUSION

Neither the PSDs or PSD Veritas group exhibited staple line complications. However, 4 leaks occurred in the patients who had Seamguards incorporated into their gastric pouch linear staple lines.

Authors+Show Affiliations

Division of Bariatric Surgery, Tufts-New England Medical Center, Boston, Massachusetts 02111, USA. Sshikora@tufts-nemc.orgNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

18586575

Citation

Shikora, Scott A., et al. "Comparison of Permanent and Nonpermanent Staple Line Buttressing Materials for Linear Gastric Staple Lines During Laparoscopic Roux-en-Y Gastric Bypass." Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, vol. 4, no. 6, 2008, pp. 729-34.
Shikora SA, Kim JJ, Tarnoff ME. Comparison of permanent and nonpermanent staple line buttressing materials for linear gastric staple lines during laparoscopic Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2008;4(6):729-34.
Shikora, S. A., Kim, J. J., & Tarnoff, M. E. (2008). Comparison of permanent and nonpermanent staple line buttressing materials for linear gastric staple lines during laparoscopic Roux-en-Y gastric bypass. Surgery for Obesity and Related Diseases : Official Journal of the American Society for Bariatric Surgery, 4(6), 729-34. https://doi.org/10.1016/j.soard.2008.02.001
Shikora SA, Kim JJ, Tarnoff ME. Comparison of Permanent and Nonpermanent Staple Line Buttressing Materials for Linear Gastric Staple Lines During Laparoscopic Roux-en-Y Gastric Bypass. Surg Obes Relat Dis. 2008 Nov-Dec;4(6):729-34. PubMed PMID: 18586575.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of permanent and nonpermanent staple line buttressing materials for linear gastric staple lines during laparoscopic Roux-en-Y gastric bypass. AU - Shikora,Scott A, AU - Kim,Julie J, AU - Tarnoff,Michael E, Y1 - 2008/06/30/ PY - 2007/11/27/received PY - 2008/02/05/revised PY - 2008/02/07/accepted PY - 2008/7/1/pubmed PY - 2009/3/4/medline PY - 2008/7/1/entrez SP - 729 EP - 34 JF - Surgery for obesity and related diseases : official journal of the American Society for Bariatric Surgery JO - Surg Obes Relat Dis VL - 4 IS - 6 N2 - BACKGROUND: Several publications have suggested that staple line buttressing might decrease staple line bleeding, increase burst pressure, and decrease the likelihood of acute failure resulting in leak. Currently, permanent and nonpermanent options are available. However, concern has been raised about the permanent buttress material and its potential for delayed strip expulsion. This study analyzed our experience with 3 different buttressing materials for creating the gastric division during laparoscopic Roux-en-Y gastric bypass. METHODS: From July 5, 2001 to May 30, 2007, 1451 consecutive patients underwent laparoscopic gastric bypass with buttressing material used for the stapled creation of the gastric pouch. Peristrips Dry (PSDs), permanent bovine pericardial strips, were used in 926 cases from July 5, 2001 to October 11, 2005. Seamguards, a synthetic bioabsorbable product, were used in 145 cases from November 2, 2004 to July 18, 2006, and PSD Veritas, remodelable, nonpermanent bovine pericardial strips, were placed in 380 patients from October 11, 2005 to May 30, 2007. All products were applied to the 60-mm-long, 3.5-mm cartridges of the EndoGIA II stapler. The ease of use, operative complications, visual bleeding, and postoperative leaks were recorded. RESULTS: The patient characteristics were comparable for all groups. All products were easy to load on the stapler, and no operative complications related to the use of the buttress materials occurred. The incidence and severity of staple line bleeding was not specifically calculated but was visually noted to be minimal in all cases. Of the 3 groups, 4 contained leaks occurred in the Seamguards group, and all were successfully managed nonoperatively. No acute leaks were discovered in the PSD or PSD Veritas groups. This difference was statistically significant (p <.001). CONCLUSION: Neither the PSDs or PSD Veritas group exhibited staple line complications. However, 4 leaks occurred in the patients who had Seamguards incorporated into their gastric pouch linear staple lines. SN - 1550-7289 UR - https://www.unboundmedicine.com/medline/citation/18586575/Comparison_of_permanent_and_nonpermanent_staple_line_buttressing_materials_for_linear_gastric_staple_lines_during_laparoscopic_Roux_en_Y_gastric_bypass_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1550-7289(08)00076-2 DB - PRIME DP - Unbound Medicine ER -