Laparoscopic sleeve gastrectomy with Sydney patch: a cohort study

Introduction
Prevalence of obesity nearly tripled between 1975 and 2016 globally, with more than 1.9 billion adults aged 18 years and older being overweight. Bariatric surgery, including laparoscopic sleeve gastrectomy, has been shown to be effective in treating obese patients by reducing BMI and treating comorbidities of obesity. However, the most severe consequence is staple line leakage at the most proximal part of the staple line, increasing morbidity, mortality, and hospital stay. Therefore, our study’s aim is to evaluate Sydney patch (SP) technique, a maneuver that reinforces proximal area of staple line using the gastric fat pad and omentum.
Patients and methods
From January 2020 to December 2020, we reviewed medical records of patients undergoing laparoscopic sleeve gastrectomy (LSG) with SP in the Bariatric Surgery Department at Ain Shams University Hospital. We included patients above 18 years old and excluded those who were young than 18 years or older than 60 years and had previous bariatric or Gastro-intestinal (GI) surgery.
Results
A total of 30 patients underwent LSG with SP between January and December 2020. Only two (6.7%) patients developed postoperative gastroesophageal reflux disease (GERD), whereas no patients had postoperative leakage or hemorrhage or gastric remnant rotation (gastric twist).
Conclusion
This study shows promising results that LSG with SP can potentially protect against gastric leakage and hemorrhage. The authors believe that SP can be potentially efficient and a cost-effective method compared with synthetic staple line reinforcement, but large randomized controlled trials (RCTs) are needed to further evaluate the effectiveness of SP in reducing morbidity and mortality after LSG.