Omentopexy in Sleeve Gastrectomy: The Game Changer for Minimizing Complications and Surgery Time in Revisional Roux-en-Y Gastric Bypass.

BACKGROUND

Laparoscopic sleeve gastrectomy (LSG) is a widely performed bariatric surgery; however, some patients experience inadequate weight loss or weight regain, requiring revisional bariatric surgery such as Roux-en-Y gastric bypass (RYGB). Omentopexy, a technical variation during LSG, may influence long-term outcomes and the complexity of subsequent surgeries. This study aims to evaluate the impact of omentopexy during LSG on perioperative outcomes and surgery duration in patients requiring revisional RYGB.

METHODS

This retrospective cohort study analyzed 62 patients who underwent revisional RYGB following primary LSG between January 2015 and January 2024. Patients were divided into two groups based on whether omentopexy was performed during the initial LSG. The primary outcomes assessed were perioperative complications, intrathoracic gastric migration (IGM), and surgery duration during RYGB. Secondary outcomes included hospital stay length and 30-day readmission rates.

RESULTS

Of the 62 patients, 56 were female and 6 were male, with a mean age of 44.3 years. The mean body mass index (BMI) was 39.5 kg/m. The omentopexy group (O-LSG) exhibited a significantly lower rate of perioperative complications (7.6%) compared to the non-omentopexy group (NO-LSG) (25%, p < 0.05). Intrathoracic gastric migration was observed in 13.8% of NO-LSG patients, while no cases were found in the O-LSG group. Additionally, surgery duration was significantly shorter in the O-LSG group (p < 0.05). No significant difference was found between the groups regarding hospital stay length or 30-day readmission rates.

CONCLUSIONS

Omentopexy during primary LSG is associated with reduced perioperative complications, shorter surgery durations, and lower rates of intrathoracic gastric migration during revisional RYGB. These findings suggest that performing omentopexy during LSG may simplify revisional procedures and improve patient outcomes.