Background

Laparoscopic sleeve gastrectomy (LSG) is a commonly performed bariatric procedure. At our institution, two vessel sealing devices, Thunderbeat (Olympus) and Maryland Ligasure (Covidien) are utilized for intraoperative dissection. In this study, we evaluated post-operative bleeding rates between the two devices. A retrospective review of all patients who underwent primary LSG from July 2013 through August 2022 was performed. All LSG were performed with staple-line reinforcement.The primary outcome measured was post-operative bleeding as defined by the Metabolic and Bariatric Surgery Accreditation and Quality Improvement Program (MBSAQIP): bleeding of the GI tract within 30 days postop and readmission, reoperation, intervention, any blood transfusion, or a critical blood pressure drop and/or increase in heart rate that results in transfer to higher level of care or administration of pressors. A total of 8157 underwent LSG. Average BMI and age were 43.2 kg/m2 and 37.1 years, respectively. 6600 (81%) were female. Thunderbeat was utilized in 5143 (63%) cases and Maryland Ligasure was used in 3014 (37%) cases.There was no significant difference in overall bleeding between the Thunderbeat (18/5143, 0.35%) and the Maryland Ligasure (19/3014, 0.63%; p=0.0689).However, there was a difference noted when comparing reoperation for bleeding between Thunderbeat (9/5143, 0.2%) and Ligasure (13/3014, 0.4%; p=0.0291).Furthermore, the location of bleeding in the reoperations was more commonly from the mesentery cut edge compared to the staple line with the Ligasure vs. the Thunderbeat (69.2% vs 33.3%; p=0.038). The Thunderbeat device is comparatively more hemostatic than the Ligasure for LSG.