Skip to main page content
U.S. flag

An official website of the United States government

Dot gov

The .gov means it’s official.
Federal government websites often end in .gov or .mil. Before sharing sensitive information, make sure you’re on a federal government site.

Https

The site is secure.
The https:// ensures that you are connecting to the official website and that any information you provide is encrypted and transmitted securely.

Access keys NCBI Homepage MyNCBI Homepage Main Content Main Navigation
. 2024 Sep;34(9):3553-3560.
doi: 10.1007/s11695-024-07357-4. Epub 2024 Aug 6.

Perioperative Outcomes Using Single-Fire Stapler

Gregory D Fritz  1 , Aryana Sharrak  2 , Jason Aubrey  2 , Xhesika Topalli  3 , Antonia Vrana  3 , Anne Opalikihn  3 , Giuseppe M Zambito  4 , Thomas D Martin  5 , James A Foote  5 , Joshua R Smith  5 , Jon L Schram  5
Affiliations

Perioperative Outcomes Using Single-Fire Stapler

Gregory D Fritz et al. Obes Surg. 2024 Sep.

Abstract

Background: 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.

Methods: 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.

Results: 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.

Conclusions: 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.

Keywords: Bariatric surgery; Sleeve gastrectomy; Stapling device.

PubMed Disclaimer

Conflict of interest statement

Gregory D. Fritz MD, Aryana Sharrak MD, Jason Aubrey MD, Xhesika Topalli, Antonia Vrana, Anne Opalikihn MD, Giuseppe M. Zambito MD, Thomas D. Martin MD, and Joshua R. Smith MD have no conflicts of interest to report. James A. Foote MD is a proctor for Teleflex. Jon L. Schram MD serves on the Scientific Advisory Board for Teleflex.

References

    1. Ward ZJ, Bleich SN, Long MW, et al. Association of body mass index with health care expenditures in the United States by age and sex. PLoS ONE. 2021;16(3):e0247307. 10.1371/journal.pone.0247307. 10.1371/journal.pone.0247307 - DOI - PMC - PubMed
    1. Barski K, Binda A, Kudlicka E, et al. Gastric wall thickness and stapling in laparoscopic sleeve gastrectomy - a literature review. Wideochir Inne Tech Maloinwazyjne. 2018;13(1):122–7. 10.5114/wiitm.2018.73362. 10.5114/wiitm.2018.73362 - DOI - PMC - PubMed
    1. Jensen MD, Ryan DH, Apovian CM, et al. 2013 AHA/ACC/TOS guideline for the management of overweight and obesity in adults: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines and The Obesity Society. Circulation. 2014;129(25 Suppl 2):S102-138. 10.1161/01.cir.0000437739.71477.ee. 10.1161/01.cir.0000437739.71477.ee - DOI - PMC - PubMed
    1. Who is a Candidate for Bariatric Surgery? | Patients | ASMBS. American Society for Metabolic and Bariatric Surgery. Accessed September 27, 2023. https://asmbs.org/patients/who-is-a-candidate-for-bariatric-surgery.
    1. Estimate of Bariatric Surgery Numbers, 2011–2021. American Society for Metabolic and Bariatric Surgery. Published June 27, 2022. Accessed September 27, 2023. https://asmbs.org/resources/estimate-of-bariatric-surgery-numbers.

LinkOut - more resources