Safety of bipolar sealing device in gastric staple-line hemostasis during laparoscopic one-anastomosis gastric bypass

Objective
Despite the rarity, the consequences of bleeding and leaks after bariatric procedures can be drastic and potentially fatal, mandating the search for preventive maneuvers. In this study, we investigated the safety and efficacy of the staple-line hemostasis using LigaSure patients subjected to one-anastomosis gastric bypass (OAGB).
Patients and methods
This prospective study involved 92 patients scheduled for OAGB. Patients were followed up during the next 2 weeks after the operation. Hemostasis of the stomach’s stapler line was done using bipolar diathermy (LigaSure) to stop the bleeding sites if present. Postoperatively, the patients were monitored regularly for clinical signs of bleeding and leakage.
Results
Operative time did not exceed 120 min. All patients during the operation suffered from bleeding from the staple line and underwent hemostasis by using LigaSure. LigaSure secured complete hemostasis within 10 min and did not cause any intraoperative or postoperative complications in the form of electrothermal injury to the surrounding structures. Two patients suffered from postoperative intraluminal bleeding from the staple line and required blood transfusion. No case of leakage was recorded. Most of the study cohort (=90, 97.8%) stayed only 1 day after surgery.
Conclusion
The bipolar diathermy device LigaSure is a promising technique for staple-line hemostasis in patients undergoing OAGB. It was not associated with increased leakage or other postoperative complications.