Tissue thickness of human stomach measured on excised gastric specimens from obese patients

Abstract

Laparoscopic linear cutting staplers are commonly used in bariatric surgery. Although many staple sizes are available, the clinical results of a staple line vary depending on the staple size and tissue environment. To help surgeons choose the proper staple size as well as establish design parameters for the development of new stapling devices, understanding the mechanical properties of the tissue is necessary. Knowing the distribution of the thickness of the stomach tissue would allow for increased accuracy in defining key design parameters for stapling devices, thus improving their performance in the operating theater. To this end, 50 sleeve/lateral gastrectomy specimens were obtained in a consecutive series from individuals undergoing weight loss surgery. Thickness measurements were performed at six predetermined sites. Results show that stomach thickness varies from thinnest at the proximal end near the esophageal junction to thickest near the pylorus. The data also suggest that the stomach is thinner along the greater curvature. Due to the variation in thickness of the stomach, laparoscopic linear cutting staplers with thicker staples are recommended when transecting the antrum. This thickness data will facilitate the development of devices with appropriate aperture closure for correct tissue compression.