Staple-Line Reinforcement in Sleeve Gastrectomy

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OBJECTIVE: To compare the frequency of postoperative complications, specifically staple-line bleeding and leakage, in patients undergoing laparoscopic sleeve gastrectomy (LSG) with and without staple-line reinforcement. STUDY DESIGN: A descriptive, analytical study. Place and Duration of the Study: Department of General Surgery, Jinnah Postgraduate Medical Centre, Karachi, Pakistan, from January 2014 to December 2024. METHODOLOGY: Patients aged 20 to 60 years, of either gender, who underwent LSG were retrospectively reviewed. A binary logistic regression was conducted to assess the association between staple-line reinforcement and postoperative bleeding, adjusting for age, gender, diabetes mellitus, hypertension, and smoking status. Results were presented as odds ratios (ORs) with 95% confidence intervals (CIs). A p-value of <0.05 was considered statistically significant. Model fit and multicollinearity were assessed before finalising the regression model. RESULTS: Staple-line reinforcement was not found to have a significant association with the reduced postoperative bleeding (OR = 0.636, 95% CI: 0.206-1.964, p = 0.432). No post-operative leakage was noted in either group. CONCLUSION: Staple-line reinforcement during LSG does not significantly reduce the incidence of postoperative bleeding or leakage. These findings suggest that the use of staple-line reinforcement material may not be essential when meticulous surgical technique is employed. Further large-scale prospective studies are recommended to confirm these results and refine surgical protocols. KEY WORDS: Laparoscopic sleeve gastrectomy, Staple-line reinforcement, Bleeding, Leakage, Bariatric surgery.

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