a_clinical_pearl Technical details during bariatric operations

[Admin]

Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

"The assistant should grasp and laterally retract the posterior wall of the stomach near the greater curvature to ensure no wall of the stomach is folded on itself causing four layers to be included in the staple line. This also prevents the sleeve from twisting as sequential firings take place, resulting in a spiral staple line."

[Admin]

Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

"Anastomotic leakage and bleeding may present initially only as sustained tachycardia; therefore, the threshold for obtaining an oral and IV contrast-enhanced CT scan in the early postoperative period should be low."

[Admin]

Quote from "The SAGES Manual of Pediatric Minimally Invasive Surgery" by Danielle S. Walsh, Todd A. Ponsky, Nicholas E. Bruns -

"Bleeding tends to occur where dissection of the gastroepiploics began, and this area should be inspected prior to removal of ports. Sleeve leaks tend to occur proximally, where visualization of the last staple firing is difficult and the esophagus may be crossed."