THE ROLE OF GASTROPEXY IN THE PREVENTION OF POST LAPAROSCOPIC SLEEVE GASTRECTOMY COMPLICATIONS

Abstract: Background: Laparoscopic sleeve gastrectomy (LSG) has documented effective outcomes regarding weight loss and improvement of comorbidities. Nevertheless, it could be associated with distressing complications like vomiting, stenosis, or reflux. Gastropexy is a surgical technique describing the fixation of the sleeve tube to the surrounding and underlying structures. It is believed that this step could significantly decrease the incidence of the previous complications. That is why we conducted our study to elucidate if gastropexy/omentopexy could improve LSG outcomes. Methodology: This prospective study included 104 patients scheduled for LSG. They were randomly divided into Gastropexy and control groups. Gastropexy was omitted in the latter. Results: Operative time, and weight loss changes were comparable between the two groups. Additionally, postoperative leakage, bleeding, port infection, and nausea did not differ between the same groups. Yet, the incidence of postoperative vomiting was higher in the control group (25% vs. 3.85% with gastropexy). Stenosis of the sleeve tube occurred in only one case in the control group. De novo reflux increased when gastropexy was omitted (21.54% vs. 3.85% with gastropexy). LSG was associated with a significant improvement in gastrointestinal quality of life, but the improvement was significantly better in association with gastropexy. Conclusion: Gastropexy leads to significant improvement in LSG outcomes. That operative step should be routinely done during such procedures to enhance perioperative outcomes.