Back in the seventies, researchers were looking for alternatives to weight loss surgery that would be safer than the jejunoileal bypass (a surgical short bowel) or Roux-en-Y (gastric bypass surgery). Mechanical surgical staplers were introduced and the first gastroplasty (stomach stapling surgery) was performed.
For more information, please visit Ezisurg.
The old stomach stapling procedure was performed by placing a line of staples running the entire length of the stomach, separating it into two sections. One section was significantly smaller than the other and was designed to be used as the primary stomach. There was a small opening left between the primary stomach and the lower portion, and the food would gradually move through the smaller side and travel to the larger side during digestion.
The procedure seemed to deliver significant weight loss of about 50% of the patient’s excess body weight in one year but the long-term weight loss results were far worse.
Stapling the stomach led to many side effects, such as the following:
Many unsuccessful modification attempts were made, but stomach stapling remained plagued by poor weight loss results and a high number of complications, so it was discontinued. Newer procedures were introduced, such as gastric sleeve surgery, which is now the most popular form of bariatric surgery.
The gastric sleeve procedure was not originally a stand-alone surgery; it was the first part of a procedure that required two different surgeries, with time to heal in between. Duodenal switch surgery was developed to treat obesity and address the complication of bile reflux. This surgery involved the creation of the gastric sleeve as part one of the procedure. Enough patients showed significant weight loss after the gastric sleeve portion of the procedure that they began using it as a stand-alone surgery. Today gastric sleeve surgery is the most often performed bariatric surgery in the United States.
Surgical staples are used during gastric sleeve surgery, but things have improved over the past 50 years. There is no comparison between the old mechanical staplers that were bulky and unreliable and were used for stomach stapling versus gastric sleeve surgery and the more advanced, streamlined surgical staplers.
Gastric sleeve surgery is most often performed laparoscopically today but still requires the use of staples and has its fair share of complications.
After the emergence of gastric sleeve surgery, advancements in medical technology and techniques continued to improve and endoscopic procedures for weight loss became available. New endoscopic tools were also created, including a state-of-the-art endoscopic suturing device.
Fortunately, there is no need for endoscopic stomach stapling because the new FDA-approved Overstitch device does a safe and effective job of securing tissue with full-thickness stitches. The overstitch device made it possible for gastroenterologists to repair complications from a previous bariatric surgery without the patient having to undergo an additional surgical procedure. And even more exciting is that it paved the way for a new non-surgical weight loss procedure called the endoscopic sleeve gastroplasty (ESG).
Are you interested in learning more about endoscopic stapler? Contact us today to secure an expert consultation!
The old gastroplasty procedure that was done with staples was a decent concept; they just did not have the right tools or technique. Today’s endoscopic sleeve gastroplasty (ESG) is a bit like a combination of the old stomach stapling procedure and modern gastric sleeve surgery, only much improved!
Gastric Sleeve vs Endoscopic Sleeve GastroplastyIt’s common for patients to ask questions about the staples we use in our Sleeve and Gastric Bypass procedures. These are questions like:
The first important thing to know is that surgical staples are NOT experimental. They’ve been used in human surgery going back to the ’s, so we know from millions of cases over very long periods of time that staples do NOT cause any adverse reactions.
Most of the time, we use surgical staplers when we need to cut across the stomach or the intestine. The surgical staplers help us be more precise, and the process cleaner, which equals safer. The process is that the stapler clamps and stabilizes the tissue, then the stapler has a surgical blade to make the cut and it has multiple rows of staples that form on each side of the cut simultaneously to seal the tissue. The clamping effect of the stapler also means that the cut is very precise; it happens exactly where the surgeon wants it to be. The staple sealing function prevents leakage and bleeding – fantastic! All this is so much better than the old way which was to make the necessary cut “free hand” then to suture the edges together in the midst of ongoing leaking and bleeding.
Check out the stapler in live surgery on YouTube here: About Staples in Bariatric Surgery
You saw that the stapler leaves behind nice clean edges that are aligned and secure, kind of like the inseam of your jeans. This kind of stable alignment is the best way to promote healing of the tissues. Bariatric surgeons typically ensure there is no leakage by doing a pressure leak test after they’ve completed the surgical anatomy.
As you can see, these are tiny little staples that are shaped a lot like the staples that you use for paper in your office. They are made from titanium, which never rusts or degrades in the body. There is no allergic reaction to titanium.
Once the sealed edges of gastrointestinal tissue knit or “fuse” back together through the natural healing process, the staples aren’t needed and these tiny bits of titanium simply float embedded in the tissue. There is ongoing research to devise absorbable staples, but so far nothing has come close to being as reliable as titanium.
So, here’s a summary of the answers to common questions about staples:
If you want to learn more, please visit our website endo stapler.