ABSTRACT
The problem of obesity has reached epidemic proportions in the USA. More than 50% of adults are obese or overweight. The only therapeutic intervention that provides effective long-term weight loss for the severely obese is bariatric surgery. Roux-en-Y gastric bypass is the most commonly performed bariatric operation in the USA. Anastomotic leaks can cause life-threatening sepsis in the immediate postoperative period or delayed presentations with fistulas. Fibrin sealant and bovine pericardium have been used to reinforce the anastomosis in order to decrease the rate of this dreaded complication. This review will summarize current literature on the subject.
Subject(s)
Anastomosis, Surgical/instrumentation , Gastric Bypass/instrumentation , Surgical Mesh , Surgical Stapling/instrumentation , Anastomosis, Surgical/methods , Gastric Bypass/methods , Humans , Surgical Stapling/methods , SuturesABSTRACT
Fibrin sealant has been used with increasing frequency in a variety of surgical field for its unique hemostatic and adhesive abilities. Fibrin sealant mimics the last step of the coagulation cascade and takes place independently of the patient's coagulation status. With rapid advances in minimally invasive surgery, the potential uses for this type of biologic and synthetic material are expanding exponentially. This article reviews the data associated with the application of fibrin sealant in various surgical procedures. From reinforcing gastrointestinal anastomosis to repair perforated duodenal ulcers to mesh fixation in laparoscopic inguinal hernia repair, fibrin sealant is gaining increasing acceptance among surgeons. The applications of fibrin sealant are expanding, and new preparations of fibrin sealant are currently being evaluated.
Subject(s)
Blood Loss, Surgical/prevention & control , Digestive System Diseases/surgery , Digestive System Surgical Procedures/methods , Fibrin Tissue Adhesive/therapeutic use , Anastomosis, Surgical/adverse effects , Anastomosis, Surgical/methods , Animals , Digestive System Diseases/diagnosis , Digestive System Surgical Procedures/adverse effects , Female , Follow-Up Studies , Humans , Intraoperative Complications/prevention & control , Male , Risk Assessment , Sensitivity and Specificity , Treatment OutcomeABSTRACT
Roux-en-Y gastric bypass is the most commonly performed bariatric operation in the USA. Anastomotic leak is one of the devastating complications in this operation. By using fibrin sealant around the anastomosis, surgeons can achieve better hemostasis around the suture-line and prevent or decrease the incidence of anastomotic leaks. This paper discusses the biological and clinical evidence for use of fibrin sealant in laparoscopic gastric bypass.
