BUTTRESSING MATERIAL REINFORCEMENT FOR STAPLE-LINE USE AND FINANCIAL IMPLICATIONS IN A DEVELOPING COUNTRY

Abstract

BACKGROUND:

Staple-line reinforcement is traditionally used in laparoscopic weight loss surgery in order to reduce bleeding and leakage. The purpose of this study was to find out the role of buttressing material Seam Guard (GORE) ® for staple-line reinforcement and its financial implications in our setup.

METHODS:

A prospective comparative study was done of morbidly obese patients who underwent weight loss surgery (Laparoscopic Sleeve Gastrectomy) over an 8-year period. Patients were enrolled in three groups; Group A received staple-line reinforcement throughout Group B only had partial reinforcement (at the fundus and pyloric end) and Group C were the ones on whom no reinforcement was used. The staple line was reinforced with Seam Guard (GORE) ®strips.

RESULTS:

A total of 364 patients, with a mean preoperative BMI of 53.3 kg/m2 (range = 37.8-68.9), underwent LSG. 146 patients were in Group A, 105 in Group B and 113 in Group C. None of the patients in all three groups had leak.

CONCLUSION:

Staple line reinforcement reduced surgical complications compared to standard stapling of the stomach for a Gastric Sleeve. No statistical significance was observed in the rates of bleeding or leaks between any of the groups. Thus the additional cost of the buttressing material such as Seam Guard (GORE) poses a financial burden on the patient considering the economic realities of our setup.