Application of triple stomach shaping technique in laparoscopic sleeve gastrectomy_CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY

Authors：

WANG Bing ¹ , YAN Tong ¹ , LUO Dan ¹ , YANG Huawu ¹ , WANG Haibo ¹ , LI Qin ¹ ,  LIU Yanjun ^1,2

1. Center of Gastrointestinal and Minimally Invasive Surgery & Center of Obesity and Metabolic Diseases, Department of General Surgery, The Third People’s Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University & The Second Affiliated Hospital of Chengdu, Chongqing Medical University, Chengdu 610031, P. R. China;
2. Institute for Obesity and Metabolic Diseases, College of Medicine, Southwest Jiaotong University, Chengdu 610031, P. R. China;

Corresponding author：

LIU Yanjun, Email: liuyanjun_001@163.com

Keywords：

triple gastric shaping technique; incisal margin suture; omentopexy; laparoscope; sleeve gastrectomy; postoperative complication

DOI：

10.7507/1007-9424.202301030

Video：

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Objective To summarize and analyze the application value of triple stomach shaping technique in laparoscopic sleeve gastrectomy (LSG). Methods The clinical data of patients undergoing simple LSG with triple stomach shaping technique carried out by the General Surgery Obesity and Metabolic Diseases Center of Chengdu Third People’s Hospital from January to December 2021 were retrospectively collected, recording the operative time and the occurrence of recent complications such as postoperative nausea/vomiting, gastric leakage, bleeding, obstruction/torsion within 30 days after operation. Results A total of 966 patients were collected, including 294 males and 672 females. The age was 16–65 years, average age was (32.8±8.6) years. Body mass index was 27.5–47.2 kg/m², average was (34.2±3.5) kg/m². All operations were successfully completed without conversion to laparotomy. The operative time was 45–170 min, average was (100.2+33.4) minutes. Postoperative nausea/vomiting occurred in 484 cases (50.10%), bleeding in 2 cases (0.21%, intraperitoneal bleeding in 1 case, intragastric bleeding in 1 case), gastric leakage in 1 case (0.10%, grade B leakage), and no perioperative death occurred. Hospitalization time was 4–24 d, average was (7.55±2.47) d. Two patients (0.21%) were hospitalized again due to nausea and vomiting within 30 days after operation, they were relieved and discharged after conservative medical treatment. Conclusion Triple gastric shaping technology is more physiological, safe and suitable for promotion.

Citation： WANG Bing, YAN Tong, LUO Dan, YANG Huawu, WANG Haibo, LI Qin, LIU Yanjun. Application of triple stomach shaping technique in laparoscopic sleeve gastrectomy. CHINESE JOURNAL OF BASES AND CLINICS IN GENERAL SURGERY, 2023, 30(3): 264-267. doi: 10.7507/1007-9424.202301030 Copy

1.	中国居民营养与慢性病状况报告(2020年). 营养学报, 2020, 42(6): 521.
2.	Carlsson LMS, Jacobson P, Peltonen M. Life expectancy after bariatric surgery—the Swedish obese subjects study reply. N Engl J Med, 2021, 384(1): 89. doi: 10.1056/NEJMc2033331.
3.	Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) indications for metabolic and bariatric surgery. Obes Surg, 2023, 33(1): 3-14.
4.	Mingrone G, Panunzi S, De Gaetano A, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet, 2021, 397(10271): 293-304.
5.	Aminian A, Wilson R, Al-Kurd A, et al. Association of bariatric surgery with cancer risk and mortality in adults with obesity. JAMA, 2022, 327(24): 2423-2433.
6.	中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 腹腔镜袖状胃切除术操作指南(2018 版). 中华肥胖与代谢病电子杂志, 2018, 4(4): 196-201.
7.	杨华, 陈缘, 董志勇, 等. 中国肥胖代谢外科数据库: 2020年度报告. 中华肥胖与代谢病电子杂志, 2021, 7(1): 1-7.
8.	李梦伊, 刘洋, 刘雁军, 等. 大中华减重与代谢手术数据库2021年度报告. 中国实用外科杂志, 2022, 42(5): 550-560.
9.	郭沛, 刘朋朋, 侯栋升, 等. 腹腔镜袖状胃切除术治疗不同肥胖程度单纯性肥胖症的疗效分析. 中国普外基础与临床杂志, 2021, 28(2): 208-211.
10.	王勇, 王存川, 朱晒红, 等. 中国肥胖及2型糖尿病外科治疗指南(2019版). 中国实用外科杂志, 2019, 39(4): 301-306.
11.	Yormaz S, Yilmaz H, Ece L et al. Midterm clinical outcomes of antrum resection margin at laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg, 2017, 27(4): 910-916.
12.	Halliday TA, Sundqvist J, Hultin M, et al. Post-operative nausea and vomiting in bariatric surgery patients: an observational study. Acta Anaesthesiol Scand, 2017, 61(5): 471-479.
13.	Clapp B, Grasso S, Gamez J, et al. Does accreditation matter? An analysis of complications of bariatric cases using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program and National Quality Improvement Program databases. Surg Obes Relat Dis, 2022, 18(5): 658-665.
14.	Mocanu V, Marcil G, Dang JT, et al. Preoperative weight loss is linked to improved mortality and leaks following elective bariatric surgery: an analysis of 548 597 patients from 2015-2018. Surg Obes Relat Dis, 2021, 17(11): 1846-1853.
15.	Bhalla S, Yu JX, Varban OA, et al. Upper gastrointestinal series after sleeve gastrectomy is unnecessary to evaluate for gastric sleeve stenosis. Surg Endosc, 2021, 35(2): 631-635.
16.	Fort JM, Gonzalez O, Caubet E, et al. Management of the staple line in laparoscopic sleeve gastrectomy: comparison of three different reinforcement techniques. Surg Endosco, 2021, 35(7): 3354-3360.
17.	Lin Y, Long Y, Lai S, et al. The effectiveness and safety of barbed sutures in the bariatric surgery: a systematic review and meta-analysis. Obes Surg, 2019, 29(6): 1756-1764.
18.	Batman B, Altun H. Benefits of suture reinforcement in laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech, 2019, 29(6): 539-542.
19.	董志勇, 王华曦, 姜舒文, 等. 三孔“七步法”腹腔镜袖状胃切除术. 中华胃肠外科杂志, 2020, 23(7): 628.
20.	董志勇, 王存川. 膜解剖理念在腹腔镜袖状胃切除术中的应用. 中华胃肠外科杂志, 2020, 23(7): 661-665.
21.	Arslan E, Banli O, Sipahi M, et al. Effects and results of omentopexy during laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech, 2018, 28(3): 174-177.
22.	Abou-Ashour HS. Impact of gastropexy/omentopexy on gastrointestinal symptoms after laparoscopic sleeve gastrectomy. Obes Surg, 2022, 32(3): 729-736.
23.	Abdallah E, Emile SH, Elfeki H. Laparoscopic sleeve gastrectomy with or without staple line inversion and distal fixation to the transverse mesocolon: Impact on early postoperative outcomes. Obes Surg, 2017, 27(2): 323-329.
24.	刘华江, 杨华, 姜舒文, 等. 腹腔镜袖状胃切除术中大网膜复位的应用及效果. 中华肥胖与代谢病电子杂志, 2018, 4(3): 146-150.
25.	Fouad MMB, Ibraheim SMN, Ibraheim P, et al. Assessment of the role of omentopexy in laparoscopic sleeve gastrectomy: A tertiary center experience. J Laparoendosc Adv Surg Tech A, 2022, 32(9): 962-968.
26.	Frosio F, Suhool A, Ferraz JM, et al. Anatomical quality criteria for sleeve gastrectomy. Obes Surg, 2021, 31(4): 1541-1548.

1. 中国居民营养与慢性病状况报告(2020年). 营养学报, 2020, 42(6): 521.
2. Carlsson LMS, Jacobson P, Peltonen M. Life expectancy after bariatric surgery—the Swedish obese subjects study reply. N Engl J Med, 2021, 384(1): 89. doi: 10.1056/NEJMc2033331.
3. Eisenberg D, Shikora SA, Aarts E, et al. 2022 American Society of Metabolic and Bariatric Surgery (ASMBS) and International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) indications for metabolic and bariatric surgery. Obes Surg, 2023, 33(1): 3-14.
4. Mingrone G, Panunzi S, De Gaetano A, et al. Metabolic surgery versus conventional medical therapy in patients with type 2 diabetes: 10-year follow-up of an open-label, single-centre, randomised controlled trial. Lancet, 2021, 397(10271): 293-304.
5. Aminian A, Wilson R, Al-Kurd A, et al. Association of bariatric surgery with cancer risk and mortality in adults with obesity. JAMA, 2022, 327(24): 2423-2433.
6. 中国医师协会外科医师分会肥胖和糖尿病外科医师委员会. 腹腔镜袖状胃切除术操作指南(2018 版). 中华肥胖与代谢病电子杂志, 2018, 4(4): 196-201.
7. 杨华, 陈缘, 董志勇, 等. 中国肥胖代谢外科数据库: 2020年度报告. 中华肥胖与代谢病电子杂志, 2021, 7(1): 1-7.
8. 李梦伊, 刘洋, 刘雁军, 等. 大中华减重与代谢手术数据库2021年度报告. 中国实用外科杂志, 2022, 42(5): 550-560.
9. 郭沛, 刘朋朋, 侯栋升, 等. 腹腔镜袖状胃切除术治疗不同肥胖程度单纯性肥胖症的疗效分析. 中国普外基础与临床杂志, 2021, 28(2): 208-211.
10. 王勇, 王存川, 朱晒红, 等. 中国肥胖及2型糖尿病外科治疗指南(2019版). 中国实用外科杂志, 2019, 39(4): 301-306.
11. Yormaz S, Yilmaz H, Ece L et al. Midterm clinical outcomes of antrum resection margin at laparoscopic sleeve gastrectomy for morbid obesity. Obes Surg, 2017, 27(4): 910-916.
12. Halliday TA, Sundqvist J, Hultin M, et al. Post-operative nausea and vomiting in bariatric surgery patients: an observational study. Acta Anaesthesiol Scand, 2017, 61(5): 471-479.
13. Clapp B, Grasso S, Gamez J, et al. Does accreditation matter? An analysis of complications of bariatric cases using the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program and National Quality Improvement Program databases. Surg Obes Relat Dis, 2022, 18(5): 658-665.
14. Mocanu V, Marcil G, Dang JT, et al. Preoperative weight loss is linked to improved mortality and leaks following elective bariatric surgery: an analysis of 548 597 patients from 2015-2018. Surg Obes Relat Dis, 2021, 17(11): 1846-1853.
15. Bhalla S, Yu JX, Varban OA, et al. Upper gastrointestinal series after sleeve gastrectomy is unnecessary to evaluate for gastric sleeve stenosis. Surg Endosc, 2021, 35(2): 631-635.
16. Fort JM, Gonzalez O, Caubet E, et al. Management of the staple line in laparoscopic sleeve gastrectomy: comparison of three different reinforcement techniques. Surg Endosco, 2021, 35(7): 3354-3360.
17. Lin Y, Long Y, Lai S, et al. The effectiveness and safety of barbed sutures in the bariatric surgery: a systematic review and meta-analysis. Obes Surg, 2019, 29(6): 1756-1764.
18. Batman B, Altun H. Benefits of suture reinforcement in laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech, 2019, 29(6): 539-542.
19. 董志勇, 王华曦, 姜舒文, 等. 三孔“七步法”腹腔镜袖状胃切除术. 中华胃肠外科杂志, 2020, 23(7): 628.
20. 董志勇, 王存川. 膜解剖理念在腹腔镜袖状胃切除术中的应用. 中华胃肠外科杂志, 2020, 23(7): 661-665.
21. Arslan E, Banli O, Sipahi M, et al. Effects and results of omentopexy during laparoscopic sleeve gastrectomy. Surg Laparosc Endosc Percutan Tech, 2018, 28(3): 174-177.
22. Abou-Ashour HS. Impact of gastropexy/omentopexy on gastrointestinal symptoms after laparoscopic sleeve gastrectomy. Obes Surg, 2022, 32(3): 729-736.
23. Abdallah E, Emile SH, Elfeki H. Laparoscopic sleeve gastrectomy with or without staple line inversion and distal fixation to the transverse mesocolon: Impact on early postoperative outcomes. Obes Surg, 2017, 27(2): 323-329.
24. 刘华江, 杨华, 姜舒文, 等. 腹腔镜袖状胃切除术中大网膜复位的应用及效果. 中华肥胖与代谢病电子杂志, 2018, 4(3): 146-150.
25. Fouad MMB, Ibraheim SMN, Ibraheim P, et al. Assessment of the role of omentopexy in laparoscopic sleeve gastrectomy: A tertiary center experience. J Laparoendosc Adv Surg Tech A, 2022, 32(9): 962-968.
26. Frosio F, Suhool A, Ferraz JM, et al. Anatomical quality criteria for sleeve gastrectomy. Obes Surg, 2021, 31(4): 1541-1548.

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Application of triple stomach shaping technique in laparoscopic sleeve gastrectomy

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