Background

The sleeve gastrectomy remains the most utilized procedure for surgical weight loss in the United States. Despite its simple concept, there remains a high variability in the technique. Recently, a novel single-fire 230 mm stapler was developed to aid standardizing and streamlining the sleeve gastrectomy. An early multisite study of the novel stapler has shown the stapler is safe and effective in pouch creation. We present our 1-year outcomes of the first 50 patients undergoing sleeve gastrectomy using the single-fire 230 mm stapler. A retrospective review of the first 50 patients undergoing sleeve gastrectomy with the single-fire stapler was performed. In all cases, the stapler was positioned 1 cm from the gastroesophageal junction, 3 cm from the incisura, and 6 cm from the pylorus. A 38 Fr bougie was passed into the antrum prior to firing the stapler. There were no significant differences between operative times or length of hospital stay. There were no leaks, no patients requiring blood transfusion or reoperation for post-operative bleeding, no readmissions within 30 days of surgery, and no incisional hernias. One patient was treated for a wound infection and 1 patient had a post-operative hematoma at the 19 mm stapler trocar site. These data support that the single-fire stapler is safe and effective at sleeve gastrectomy creation. Preliminary data suggests that there may be greater excess body weight loss and decreased rates of postoperative GERD compared to other techniques used for sleeve gastrectomy at our institution.