The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

The use of Tisseel®

in Bariatric Surgery

Bariatric and Metabolic Unit Desenzano del Garda

Fabrizio Bellini

The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

of fibrin glue (Tisseel®):

AIMTo asses the effectivenes and the safety

- around the anastomoses in LRYGBP in the prevention of anastomotic leaks

- sprayed on the abdominoplsty to prevent seromy

The use of Tisseel® in Bariatric Surgery

“Gastro-jejunal leak”

(range 0.1-4.3%)

LRYGBP Major Complication

The efficacy of fibrin sealant in preventing leaks after LRYGBP has been reported in :

NON RANDOMIZED trials - Nguyen et al, Sapala et al (2004),

- Liu et al (2004), Carbajo & Garcia-Caballero (2005) RANDOMIZED trials

- Silecchia et al (2008)

The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

January 2004 al December 2012

290 LRYGBP ( 177 e 113 ) “Simplified tecnique”.

Antecolic

Antegastric

Linear stapler for gastro-jejunostomy

Side to side stapled jejuno-jejunostomy

No closure of the defects

The use of Tisseel® in Bariatric Surgery

BILIOPANCREATIC LIMB

60 cmALIMENTARY LIMB

200 cm

SIMPLIFIED LAPAROSCOPIC

GASTRIC BYPASS

The use of Tisseel® in Bariatric Surgery

• 4 mini leaks “gastro-jejunal” conservative

• 1 early “jejunal leak” on surgical intraoperative manipulation

lesion

Early Complications

5 major ( 1,72%)

290 LRYGBP

The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

41 no Tisseel®

84 with Tisseel®

125 Abdominoplasty

From January 2004 to December il 2012

1 Postoperative bleeding 1Hematoma 2 long lasting seroma

30% serum production

The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

The use of Tisseel® in Bariatric SurgeryThe use of Tisseel® in Bariatric Surgery

The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

The use of Tisseel® in Bariatric Surgery

SICOB Cagliari, 2013

CONCLUSIONCONCLUSION

• Effective in the reduction of anastomotic leak

• Lower % (0%) of leaks compared to international data (4,3%)

• No prolongation of operative time and p.o. course

• Reduction of seromy in abdominoplasty

Fibrin glue seems:

Thank You.