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Surgical glue and LSG

Surgical glue is safe and cost-effective for sleeve gastrectomies

In total, 193 patients were treated and received either standard stapling (n=99, group 1) or surgical glue reinforcement (n=94, group 2)
Surgical glue use was also associated with a significant reduction in the initial inpatient cost (€5,488 vs €6,152, p=0.005)

Using surgical glue instead of standard stapling during a laparoscopic sleeve gastrectomy is safe and cost-effective, according to a study published in the Journal of Evaluation in Clinical Practice. The study, ‘Surgical glue in laparoscopic sleeve gastrectomy: An initial experience and cost-effectiveness analysis’, was published in the Journal of Evaluation in Clinical Practice.

According to researchers from CHU de Montpellier, France, led by Dr Gregoire Mercier, gastric leaks and bleeding are the most frequent complications from LSG procedures and are associated with “a high clinical and economic burden” and the best method of staple line reinforcement in LSG is under debate.

The aim of their study was to assess the safety, efficiency, and relative cost-effectiveness of surgical glue used to perform LSG in morbid obese adults, compared with standard stapling. The researchers include all consecutive patients undergoing LSG at Montpellier University Hospital from 2011 and 2012. In total, 193 patients were treated and received either standard stapling (n=99, group 1) or surgical glue reinforcement (n=94, group 2). Both clinical and economic outcomes were measured after six months.

Outcomes

The investigators report that the duration of intervention was significantly shorter in group 2 (68 vs 82 minutes, p=0.001) and group 2 was also associated with a reduced initial length of stay (4.8 vs 5.2 days, p=0.01). There was no significant difference regarding complications, but leaks in group 1 were more severe.

Six-month readmissions and total length of stay were also shorter in group 2 (5.5 vs 6.1 days, p=0.003). Surgical glue use was also associated with a significant reduction in the initial inpatient cost (€5,488 vs €6,152, p=0.005) and in the six-month total inpatient cost, including readmissions (€6,006 vs €6,754, p=0.005). The incremental cost of glue to avoid a severe complication was −€5,446.33 (95 confidence interval, −8202.01 to −2690.66).

“Surgical glue might be a safe and cost-effective intervention in laparoscopic sleeve gastrectomy,” the authors concluded.

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