Abstract Aim To evaluate the effect of adding omentopexy to laparoscopic sleeve gastrectomy (LSG) compared to LSG alone on operative outcomes, postoperative complications, and weight loss in patients undergoing sleeve gastrectomy. Method A systematic review was conducted using PRISMA guidelines. We evaluated all complete studies comparing outcomes of LSG with omentopexy (LSGO) versus LSG only, focusing on operative time, bleeding rate, leakage rate, postoperative GORD rate, length of stay, readmission rate, reoperation rate, and 1-year weight loss rate. Random effects modelling was applied for the analyses. The certainty of evidence was assessed using the GRADE system. Results Analysis of 12 852 patients from 30 studies showed that adding omentopexy to LSG reduced the risk of postoperative leakage (OR: 0.16, P 0.00001), the risk of postoperative bleeding (OR: 0.39, P 0.00001), the risk of gastric torsion (OR: 0.19, P = 0.0001), the risk of postoperative peri-gastric collection (OR: 0.25, P = 0.06) , the risk of postoperative vomiting (OR: 0.37, P 0.00001), the risk of postoperative nausea (OR: 0.47, P 0.00001), readmission rate (OR: 0.43, P = 0.005) and postoperative GOERD symptoms beyond 6 months (OR: 0.55, P = 0.002) compared to LSG alone but increased operative time (mean difference MD: 12 min, P 0.0001). No significant differences were observed in, length of stay (MD: −0.3 days, P = 0.04), reoperation rates (OR: 1.15, P = 0.81), or 1-year weight loss rates (MD: −0.03%, P = 0.97). Conclusion Omentopexy in LSG may reduce the risk of several postoperative complications including leakage, bleeding, gastric torsion and GORD, without compromising weight loss outcomes. However, this benefit comes at the cost of increased operative time. These findings may be subject to selection bias and possible type II error and should be interpreted with caution. Therefore, further prospective trials are needed to confirm these observations.
Ibrahim et al. (Thu,) studied this question.