Use of Advanced Bipolar Energy to Control Visible Vessels Near the Staple Line for Better Hemostasis in Laparoscopic Sleeve Surgery

Aim: This study aimed to compare bleeding rates, need for reoperation, transfusion requirements, and operative time between patients managed with clipping alone and those with the combined technique. Subjects and Methods: This prospective study was undertaken on patients who underwent sleeve gastrectomy for morbid obesity. Patients were divided into two equal groups. In the Clipping Group, only clipping was used as the hemostatic method. In the Combined Group, both clipping and electrocoagulation of vessels near the staple line were employed. A drainage volume exceeding 150 mL and a persistent pulse rate above 105 beats per minute were considered significant bleeding. Results: The study analyzed data from 1,000 patients who underwent laparoscopic sleeve gastrectomy (LSG). Blood transfusion was required in 5% from the clipping group compared with 1% in the combined group. A second surgical intervention was needed in 1.4% from the clipping group and only 0.2% in the combined group. No anastomotic leaks or mortalities were reported in either group. Postoperative bleeding was significantly higher in the clipping group. The average operation time was significantly longer in the clipping group. Conclusion: Electrocoagulation of vessels near the staple line, in addition to clipping, provides superior hemostatic control without increasing the postoperative complications.