Laparoscopic Sleeve Gastrectomy with Interrupted Sutures Omentopexy, Does a Simple Addition Change the Outcome?

Document Type : Original Article

Authors

Department of General Surgery, Faculty of Medicine, Ain-Shams University, Egypt

Abstract

Background: Obesity is a major risk for mortality and morbidity. After failure of conservative management, the
only way out is a bariatric procedure. The Laparoscopic Sleeve Gastrectomy (LSG) is the most frequently performed
bariatric procedure worldwide. It is easier and has a shorter learning curve than other bariatric procedures. In this
study we addressed a modified technique for omental reattachment to the staple line during LSG and its value in
decreasing early postoperative complications.
Patients and methods: This was a concurrent cohort study, which involved 119 patients who underwent LSG for
a valid indication in adDemerdash Hospital, Ain-Shams University. Patients were randomly allocated into 2 Groups,
Group A (n=60), underwent a LSG followed by a modified omentopexy, while Group B (n=59), underwent LSG with
no omentopexy.
Results: Males represented 27.7% of patients, the mean age was 38.7 years old. The mean BMI was 48.22 kg/
m2. The sleep apnea was reported in 30.25% of patients, followed by hypertension in 24.3%, DM in 15.9%,
and GERD in 5.8% of the patients. The mean intra-operative blood loss was 11.5±3.7 cc, the operative time was
significantly longer in the MOP group, p < 0.001. Leakage was detected in a single case and gastric sleeve twist
was observed in 2 cases in Group B, while postoperative GERD was presented in 8.33% of Group A and 16.94% in
Group B. Vomiting was reported in 16.8% of the patients at first day postoperative this number declined to 5.8%
at both 1-week and 1-month follow-up visits. The median of number of attacks of vomiting per day in the first day
postoperative was 0 with range of 0-5. There was significant decrease in vomiting in the MOP in the 1-week and
1-month follow-up visits.
Conclusion: The modified omentopexy (MOP) is a simple addition to the LSG, with the added value of reducing
some postoperative complications and symptoms, mainly the postoperative nausea and vomiting attacks.

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