4- Glubran®2 in bariatric surgery

The experience of the use of nebulized Glubran®2 in strengthening the suturing line in the laparoscopic sleeve gastrectomy (LSG) held at the General Surgery Unit and Liver Transplant (Dir. Prof. V. Memeo) of the University Teaching Hospital of Bari, was presented at the recent Congress of the Italian Society for the Surgery of Obesity (SICOB ). It perfectly fits the context of the applications discussed and presented at the SICO Symposium, supporting and completing the rational use of this medical device, already commonly used as a haemostatic agent, in the treatment of anastomotic leaks, and in digestive endoscopy, and as a reinforcement of the mechanical anastomosis in open and laparoscopic surgery. The LSG is currently held, unanimously, a bariatric procedure simple, rapid and less invasive and / or complex of other procedures, such as the gastric bypass (L-RYGB), and the biliary pancreatic diversion (BPD), decreeing its worldwide success. The more or less standardized procedure presents some controversial details on the technique (D’Ugo S et al., Surg Obes Relat Dis. 2014). The rare major complications (1-3%) consist in leaks and bleeding, and are related to the long suture line. This causes an adverse impact on clinical outcomes and on health service costs, therefore most of the surgeons use a buttress for that suture line (Knapps et al., JSLS. July 2013). In fact, the validity of the use of the buttress is still being discussed because the evidences in the literature are not converging. The results of a review of 2009 show that the buttress “not necessarily” reduces the occurrence of fistulas, despite having a favourable impact on the incidence of bleeding (Chen B et al., Obes Surg. 2003)………………………………Read more