Background

Bleeding from surgical staple lines is an uncommon but potentially serious complication after bariatric surgery. Staple line reinforcement has been proposed as a method of reducing postoperative bleeding. We reviewed all patients undergoing robotic sleeve gastrectomy (RSG) and laparoscopic sleeve gastrectomy (LSG) at our institution to determine whether staple line reinforcement had a meaningful impact on bleeding rate.

Methods

All patients undergoing RSG and LSG from 2017-2020 were reviewed. Patient demographics, comorbidities, use of staple line reinforcement, and postoperative complications were analyzed. We defined significant postoperative bleeding as a hemoglobin drop greater than two points, need for transfusion, or reoperation for bleeding.

Results

A total of 1123 patients were included in the study, with 124 (11%) in the RSG group and 999 (89%) in the LSG group. Of the patients who underwent LSG, 800 (80%) patients had staple line reinforcement utilized, while 199 (20%) did not. No patients in the RSG group had reinforcement. Thirteen (1.2%) patients had significant postoperative bleeding. Patients with staple line reinforcement had fewer bleeding events (0.5%, n=4) compared to patients without reinforcement (2.8%, n=9), p<0.005.

Conclusions

The use of staple line reinforcement is associated with lower postoperative bleeding.