Modified sleeve gastrectomy technique with Hemoben hemostatic powder: prevention of early postoperative bleeding.

Abstract

Postoperative bleeding from the staple line remains a significant complication after laparoscopic sleeve gastrectomy, occurring in 0.6%-3.4% of cases. This study presents a modified surgical technique utilizing Hemoben hemostatic powder combined with omental reinforcement to prevent early bleeding complications. Between 2019 and 2022, 187 patients with morbid obesity underwent laparoscopic sleeve gastrectomy. The intervention group (n = 95) received the modified technique with Hemoben powder application and distal staple line reinforcement with omentum, while the control group (n = 92) underwent conventional oversewing. The modified technique demonstrated lower bleeding rates (1.05% vs 3.26%, P = .36, Fisher's exact test; 95% confidence intervals provided), reduced operative time by 10-15 min, and decreased transfusion requirements. No reoperations for bleeding were needed in the intervention group compared to one case in controls. The technique is simple, cost-effective, and provides reliable hemostasis without prolonging surgery duration. This modified approach demonstrates promising observational results as an alternative for preventing staple line bleeding in sleeve gastrectomy procedures and requires prospective multicenter validation.