Original articleUse of bioabsorbable staple reinforcement material in gastric bypass: a prospective randomized clinical trial
Section snippets
Methods
Patients selected to undergo gastric bypass surgery for the treatment of morbid obesity were enrolled in this study. Eligible patients were >18 years of age and had a body mass index of ≥40 kg/m2. Those patients with a body mass index of ≥35 kg/m2 and co-morbidities according to the guidelines of the National Institutes of Health Consensus Development Conference Statement of March 25–27, 1991 were also enrolled in this study [13]. The exclusion criteria for the study were the presence of
Results
A total of 48 patients undergoing laparoscopic RYGB were randomly allocated to 2 groups according to the use of polyglycolide acid and trimethylene carbonate (Seamguard) in an investigator-initiated study. Both groups consisted of 24 patients. The 2 groups were fairly well matched with respect to body mass index, age, and gender ratio (Table 1). The minimal follow-up was 12 months.
For gastric pouch construction, 4.0 ± .59 and 4.3 ± .56 staple magazines were used in groups 1 and 2, respectively (
Discussion
The complications associated with the use of surgical stapling devices include bleeding, technical failure of the instruments, inadequate approximation of the tissues, stricture, enteric leakage, and fistula [15]. Randomized prospective clinical trials have demonstrated the safety and effectiveness of staple line reinforcement using bovine pericardial strips [9], [10]. However, reinforcement with bovine pericardial strips has drawbacks. This material is nonresorbable [16] and can persist as a
Disclosures
The authors have no commercial associations that might be a conflict of interest in relation to this article.
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Cited by (72)
Clinical outcomes of pre-attached reinforced stapler reloads in bariatric surgery: A prospective case series
2021, International Journal of Surgery OpenCitation Excerpt :Due to the limited size of the present analysis, direct comparisons may not be reliable, but these results provide an indication of equivalent, to potentially improved outcomes. There is not complete agreement in the literature about the efficacy of staple line reinforcement [11,21–23]. One potential contributor to the uncertainty may be the different effects reported on different outcomes.
Laparoscopic Roux-en-Y Gastric Bypass: Surgical Technique and Perioperative Care
2016, Surgical Clinics of North AmericaUse of bioabsorbable staple reinforcement material in side-to-side anastomoses: Suture line reinforcement of the weak point of the anastomosis
2016, Annals of Medicine and SurgeryCitation Excerpt :One such possibility is the use of buttress reinforcement materials. Buttress reinforcement materials are comprised of various synthetic polymers and biologically derived materials [10–17]. Examples of clinically available buttress reinforcement materials are bovine pericardium (Peri-strips), expanded-poly-tetrafluoroethylene carbonate (TMC), copolymer (Gore Seamguard), urinary bladder matrix (MatriStem), and small intestinal submucosa (Surgisis).
Technique or technology? Evaluating leaks after gastric bypass
2016, Surgery for Obesity and Related DiseasesThe efficacy of staple line reinforcement during laparoscopic sleeve gastrectomy: A meta-analysis of randomized controlled trials
2016, International Journal of Surgery