Measurement of Stomach Wall Thickness to Guide Staple Selection during Sleeve Gastrectomy

Yoo Jin Lee, You Na Kim, Sungsoo Park

Research output: Contribution to journalArticlepeer-review

Abstract

Background: Sleeve gastrectomy has been considered a primary bariatric surgery; however, surgeons concerned with staple line leakage often query whether staples selected during stomach resection are of an appropriate size. This study aimed to measure gastric wall thickness using pathology laboratory measurements and to identify variables correlated with stomach wall thickness in patients who had undergone laparoscopic sleeve gastrectomy. Methods: We obtained fresh resected stomach wall specimens from 30 patients. Stomach wall thickness was immediately measured postoperatively, comprising the muscle layer of the antrum, body, and fundus. Results were correlated with body mass index (BMI), age, and sex and with diagnoses of presurgical diabetes, hypertension, hyperlipidemia, and fatty liver. Results: Stomach wall thickness ranged from 3.4 ± 4.3 mm to 1.0 ± 9.6 mm at the antrum. Except for the whole layer at the body wall, there was no significant correlation between wall thickness and other factors. At the body wall, whole layer wall thickness was found to positively correlate with age, sex, diabetes, and smoking (r = 0.469, − 0.391, 0.396, and 0.349, respectively; p < 0.05 in all patients). Conclusion: Stomach wall thickness varied among patients who had undergone laparoscopic sleeve gastrectomy according to samples taken at three stomach wall sites. The range in wall thickness was normal, and thus, surgeons need not hesitate in selecting the staple height. Also, our study may be helpful to guide surgeon choice concerning the third or fourth staple around the body area when considering a patient’s independent factors.

Original languageEnglish
Pages (from-to)2140-2146
Number of pages7
JournalObesity Surgery
Volume30
Issue number6
DOIs
Publication statusPublished - 2020 Jun 1

Keywords

  • Laparoscopic sleeve gastrectomy
  • Staple height
  • Stomach wall thickness

ASJC Scopus subject areas

  • Surgery
  • Endocrinology, Diabetes and Metabolism
  • Nutrition and Dietetics

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