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Over-the-Scope Clip (OTSC) System for Sleeve Gastrectomy Leaks

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Abstract

Background

Laparoscopic sleeve gastrectomy (LSG) is currently being widely accepted for its role in the treatment of morbid obesity. Staple-line leakage is one of the most reported complications found in 0.5–7 % of the population, in which the Over-the-Scope Clip (OTSC) (Ovesco Endoscopy, Tübingen, Germany), a novel device, is employed. We present our experience with this system in LSG leaks.

Methods

A retrospective analysis of prospectively collected data from patients with LSG leakage was performed, and these patients were treated with the OTSC system. Efficiency was defined as complete oral nutrition without any evidence of additional leakage.

Results

Overall, 26 patients underwent endoscopic OTSC treatment. The median age was 39 years (range 26–60), and 12 were male patients (46.15 %). The mean body mass index (BMI) was 42.89 kg/m2, and 10 patients (38.46 %) came from a revisional bariatric procedure (SRVG or LAGB). Twenty-two patients (84.61 %) had upper staple-line leaks (near the GEJ), and the remaining 4 (15.38 %) had lower antral leaks.

Number of endoscopy sessions ranged from 2 to 7 (median 3). There were five failures: 2 of them had an antral leak, and the remaining 3 had an upper staple-line leak. Twenty-one (80.76 %) leaks were successfully treated within 32 days’ median time till complete oral nutrition was attained (range 14–70).

Conclusions

The success rate was high with the OTSC system, and it is concluded to be a safe and effective treatment for LSG leaks.

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Conflict of Interest Disclosure Statement

Dr. Dean Keren has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

Dr. Ori Eyal has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

Dr. Gideon Sroka has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

Dr. Tova Rainis has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

Dr. Asnat Raziel has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

Dr. Nasser Sakran has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

Dr. David Goitein has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

Dr. Ibrahim Matter has completed the ICMJE uniform disclosure form at www.icmje.org/coi_disclosure.pdf and declares no support from any organization for the submitted work; no financial relationships with any organizations that might have an interest in the submitted work in the previous 3 years; and no other relationships or activities which could appear to have influenced the submitted work.

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Authors and Affiliations

  1. Department of Gastroenterology, Bnai-Zion Medical Center, affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    D. Keren & T. Rainis

  2. Department of General Surgery, Bnai-Zion Medical Center, affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    O. Eyal, G. Sroka & I. Matter

  3. Israeli Center for Bariatric Surgery (ICBS), Assia Medical Group, Assuta Medical Center, Tel Aviv, Israel

    D. Keren, A. Raziel, N. Sakran & D. Goitein

  4. Department of Surgery A, Emek Medical Center, Afula, affiliated with Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel

    N. Sakran

  5. Department of Surgery C, Sheba Medical Center, Tel Hashomer, affiliated with Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel

    D. Goitein

  6. Gastroenterology Unit—Bariatric Gastroenterology Clinic, Bnai-Zion Medical Center, Technion-Israel Institute of Technology, 47 Golomb Ave, POB 4840, Haifa, 31048, Israel

    D. Keren

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  1. D. Keren
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  2. O. Eyal
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Correspondence to D. Keren.

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Keren, D., Eyal, O., Sroka, G. et al. Over-the-Scope Clip (OTSC) System for Sleeve Gastrectomy Leaks. OBES SURG 25, 1358–1363 (2015). https://doi.org/10.1007/s11695-014-1540-3

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