Bures C, Seika P, Denecke C, Pratschke J, Zorron R. ROUTINE USE OF V-LOCK® SUTURE FOR BARIATRIC ANASTOMOSIS IS SAFE: COMPARATIVE RESULTS FROM CONSECUTIVE CASE SERIES.
ACTA ACUST UNITED AC 2019;
32:e1452. [PMID:
31644672 PMCID:
PMC6812141 DOI:
10.1590/0102-672020190001e1452]
[Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/25/2019] [Accepted: 05/02/2019] [Indexed: 01/31/2023]
Abstract
Background:
In high-income countries, morbid obesity is a growing health problem that
has already reached epidemic proportions. When performing a laparoscopic
gastric bypass several operative methods exist.
Aim:
To describe the institutional experience using a knotless unidirectional
barbed suture (V-Loc 180/Covidien, Mansfield, MA) to create a hand-sewn
gastrojejunostomy (GJ) and jejunojejunostomy (JJ) during bariatric surgery.
Methods:
Evaluation of a case series of 87 morbidly obese patients who underwent
laparoscopic gastric bypass with a hand-sewn gastrojejunostomy (GJA) and
jejunojejunostomy (JJA) between 01/2015 and 06/2017. The patients were
divided into two groups: in group I, GJA und JJA sutures were performed
using the knotless unidirectional barbed suture; in group II, GJA and JJA
were sutured with resorbable multifilament thread (Vicryl® 3/0
Ethicon, Livingstone, UK). The recorded data on gender, age, BMI, ASA score,
operative time, postoperative morbidity, length of hospital stay, and
reoperation, were analyzed and compared.
Results:
All procedures were completed laparoscopically with no mortality. The mean
operative time was 123.23 (±30.631) in group I and 127.57 (±42.772) in group
II (p<0.05). The postoperative complications did not differ significantly
between the two groups. Early complications were observed for two patients
(0.9%) in the barbed suture group and for one patient (0.42%) in the
multifilament suture group (p<0.05). In group I two patients (0.9%)
required reoperation: on the basis of jejunojejunal stenosis in one patient,
and local abscess near the gastrojejunostomy, without a leakage, in the
other. In group II one patient (0.42%) required reoperation due to stenosis
of the GJA. The duration of hospital admission was similar for both groups:
3.36 (±0.743) days in group I vs. 3.38 (±1.058) days in group II
(p<0.05).
Conclusion:
The novel anastomotic technique is a safe and effective method and can be
applied to gastrojejunal anastomosis and jejunojejunal anastomosis in
laparoscopic gastric bypass.
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