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Background In laparoscopic sleeve gastrectomy, patients may experience some post-operative complications as hemorrhage or leakage.We aim by this study to evaluate the benefit of omental fixation with full thickness stitches in decreasing post-operative hemorrhage and leakage, and the mutual effect on the patient and the surgeon. Methods A retrospective analysis of collected data including 200 laparoscopic sleeve gastrectomy (LSG) from September 2016 to September 2018, procedures were divided into two groups, group A of 100 LSG procedures without omental fixation but clipping the whole suture line with titanium clips if any bleeding point present, and group B 100procedures with omental fixation with full thickness stitches till the level of incisura above, and below with titanium clips to control bleeders if present. Results Of group A there were 9 cases of leakage needed intragastric stent and feeding jejunostomy (0.9%), 26 cases of bleeding (2.6%) 15 cases of them needed relaparoscopy and ful lthickness stitches (1.5%) and 11 cases of them managed conservatively with blood transfusion (1.1%), and 3 cases of perigastric localized collection managed by pigtail and antibiotics (0.3%), average operative time was 55 minutes (between 35-75 minutes).Of group B there were 8bleeding cases of drain with less than 300 cc were managed conservatively (0.8%), and 1 case of perigastric localized collection managed conservatively without pigtail (0.1%), No leakage was identified nor hematoma, average operative time 85 minutes (between 50 to 120 minutes). Conclusion The step of omental fixation with full thickness stitches has shown to be effective in decreasing staple line bleeding and leakage although it minimally prolongs the operative time of LSG.

Effects and Results of Omentopexy During Laparoscopic Sleeve Gastrectomy on Possible Post Operative Bleeding and/or Leakage