As in all craftsmanship, the technique applied in surgery has great importance. Since the first days of obesity surgery, the most undesirable complication has been leakage and right after bleeding. As bariatric surgery continues to be applied, both its effects on the patient and the mechanisms behind the complications have begun to be understood.
In case of pressure increase in a closed area, puncture will occur at the weakest point. The reflection of this information in gastric sleeve surgery is leakage complication. After the stomach is sleeved, the weakest point is upper part(fundus) of the stomach. Typically, leaks after sleeve gastrectomy occur from this point. This subject required us to pay more attention to this area while creating our surgical technique.
Bleeding can be seen as a result of continued blood flow from the cut vessels despite the staples we use. During the surgery; most of the surgeons can see this. However in some cases, there is no bleeding on thhe staple line during the surgery, but bleeding can be seen in the first few days after the surgery due to retching, straining or sudden changes in blood pressure.
Several methods are used to prevent bleeding. The most popular and the easiest one is the use of clips. In this application, clips of approximately 1 cm in length are placed on the bleeding areas of staple line and do not cover the whole staple line. However, as we have explained before, bleeding does not only occur from the visible area. On the contrary, the vast majority of postoperative bleeding is caused by areas that are safe during surgery.
After years of experience and thousands of cases, we have decided that the best way to deal with these problem is to stitch and close the entire staple line. On the other hand, the clip method has no effect in securing the staple line.
As you can see our method kills two birds with one stone by strengthening the whole staple line for leakage and controlling vessels for bleeding all together.
Moreover these clips can cause problematic staple firings, if a revisional surgery in the future will be needed.