Corewell Health Department of General Surgery, 1900 Wealthy St SE, Suite 250, Grand Rapids, MI, 49506, USA.
Corewell Health - Grand Rapids/Michigan State University General Surgery Residency, Corewell Health, Grand Rapids, USA.
Obes Surg. 2024 Sep;34(9):3553-3560. doi: 10.1007/s11695-024-07357-4. Epub 2024 Aug 6.
Laparoscopic sleeve gastrectomy (LSG) is the most common bariatric surgery performed worldwide. The Titan stapler aims to standardize the sleeve gastrectomy by eliminating inconsistencies and simplifying the procedure.
A retrospective chart review was performed on all patients > 18 years of age undergoing LSG using the Titan. Pre-operative demographics, perioperative findings, and post-operative complications were all abstracted from the MBSAQIP database.
A total of 807 LSG have been performed using the latest iteration of the Titan stapler since November 2022. Data from these patients was compared to 3829 patients who underwent LSG using a sequential staple firing technique from September 2016-September 2021. The median age of Titan patients was 42 years (IQR 33-52) compared to 44 years (IQR 35-54) for sequential firing. The median pre-operative BMI was 47.1 (IQR 43.5-52.1) for Titan versus 47.6 (IQR 43.1-53.3) for sequential staple firing. After propensity matching, operative duration was significantly less for the Titan. Titan patients had decreased hospital length of stay, experienced fewer 30-day readmissions, and had less post-operative nausea/vomiting. Post-op bleed rates were similar between the two cohorts. Weight loss at 6 months favored the sequential fire arm, but our preliminary data shows this difference diminishes at 1 year.
Here we report our data on patients undergoing LSG using the latest Titan stapler. We show the device is safe, effective, and has resulted in an improvement in length of stay, readmissions, and post-operative nausea/vomiting. We also noted reduced operative time with this technique.
腹腔镜袖状胃切除术（LSG）是目前全球应用最广泛的减重手术。Titan 吻合器旨在通过消除差异和简化手术过程来标准化袖状胃切除术。
对 2022 年 11 月以来使用 Titan 吻合器进行 LSG 的所有年龄大于 18 岁的患者进行回顾性图表审查。从 MBSAQIP 数据库中提取术前人口统计学、围手术期发现和术后并发症的所有数据。
自 2022 年 11 月以来，使用最新迭代的 Titan 吻合器共进行了 807 例 LSG。将这些患者的数据与 2016 年 9 月至 2021 年 9 月期间使用连续吻合器吻合技术进行 LSG 的 3829 例患者的数据进行比较。Titan 患者的中位年龄为 42 岁（IQR 33-52），而连续吻合器吻合的患者为 44 岁（IQR 35-54）。Titan 的中位术前 BMI 为 47.1（IQR 43.5-52.1），而连续吻合器吻合的患者为 47.6（IQR 43.1-53.3）。在倾向评分匹配后，Titan 的手术时间明显减少。Titan 患者的住院时间缩短，30 天再入院率降低，术后恶心/呕吐发生率降低。两组术后出血率相似。6 个月时的体重减轻有利于连续吻合器吻合，但我们的初步数据显示，这一差异在 1 年后会减小。
我们在此报告使用最新 Titan 吻合器进行 LSG 的患者数据。我们证明该设备安全、有效，并且缩短了住院时间、减少了再入院率和术后恶心/呕吐。我们还注意到这种技术的手术时间缩短。
