Clinical Outcomes of Alternate Laparoscopic Linear Stapler in Primary Sleeve Gastrectomy: A Single-Center Retrospective Study of Safety and Feasibility

Purpose: Staple line bleeding and leak are recognized sources of morbidity in sleeve gastrectomy, with reported rates of 1-5% and 1-3%, respectively. This study evaluated the safety and feasibility of an alternate laparoscopic linear stapling device in primary sleeve gastrectomy. Materials and Methods: ; n=18). Primary outcomes were staple line bleeding, leak, and reoperation rates. Secondary outcomes included estimated blood loss, length of hospital stay, 30-day complications, and 1-month weight loss. Results: No staple line complications were observed: staple line bleeding 0% (95% confidence interval [CI], 0-3.7%), leak 0% (95% CI, 0-3.7%), and reoperation 0%. Estimated blood loss was 98.3±42.5 mL (P=0.362) and length of stay 5.1±0.5 days (P=0.758), both uniform across BMI groups. A standardized stapler configuration (1 Black + 4-5 Purple cartridges) was used in over 90% of cases regardless of BMI class. At 1-month follow-up, % total weight loss by group was 11.75±3.35%, 13.42±6.37%, and 13.79±4.27% for Classes I, II, and III, respectively, and % excess weight loss was 49.93%, 41.43%, and 33.41%. Conclusion: The alternate laparoscopic linear stapler demonstrated a favorable safety profile in primary sleeve gastrectomy, with no observed staple line complications across BMI categories. Larger multicenter comparative studies with longer follow-up are warranted to confirm these findings.