Omentopexy in sleeve gastrectomy and its effect on postoperative complications

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Abstract

Background
Sleeve gastrectomy is an effective and relatively safe procedure for morbid obesity. Diagnosis of leakage is mainly based on clinical suspicion rather than laboratory and radiological evidence.
Aim
To evaluate the benefit of omental reattachment with full-thickness stomach stitches during laparoscopic sleeve gastrectomy (LSG) in decreasing postoperative hemorrhage and/or leakage.
Patients and methods
A retrospective analysis was conducted on the collected data from 100 cases that were divided into two groups: group I included 50 cases that underwent LSG procedures with no omental reattachment, and group II included 50 cases that underwent LSG procedures with omental reattachment with full-thickness staple line of sleeved stomach stitches till the level of angle of His above and to the antrum below from April 2019 to April 2020 at Bariatric Surgery Unit of the General Surgery Department of Ain Shams University Hospitals.
Results
There was a statistically significant difference between the two groups regarding the operation time and drain content and amount. There was a decrease of postoperative bleeding between the two groups from 12% in group I to 0% in group II, with value of 0.4, indicating slight significant difference. It also showed no difference in the percentage of postoperative leakage, as it was 1% in both groups.
Conclusion
A decrease in incidence of bleeding postoperatively can be achieved by omental fixation to the sleeved stomach by full gastric thickness stitches; it will decrease patient’s morbidity and mortality, as it decreases hospital stay and possibility of blood transfusion.

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