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Various reinforcement techniques have been used to prevent postoperative bleeding. Among them, placing seromuscular sutures or oversewing the staple line is the most cost-effective and commonly used method in Korea. This procedure usually takes some time in the early learning curve of SG and can be decreased to approximately 10–15 minutes along with the accumulation of surgical experience. Continuous oversewing with a barbed suture material may further reduce the overall procedure time. Arndtz K, Steed H, Hodson J, Manjunath S. The hidden endoscopic burden of sleeve gastrectomy and its comparison with Roux-en-Y gastric bypass. Ann Gastroenterol. 2016;29(1):44-9. Levy JL, Levine MS, Rubesin SE, Williams NN, Dumon KR. Stenosis of gastric sleeve after laparoscopic sleeve gastrectomy: clinical, radiographic and endoscopic findings. Br J Radiol. 2018;91(1089):20170702. doi:10.1259/bjr.20170702 When applied to posts that meet the requirements of BS8417:2012 - UC4 (Use Class 4). See guarantee for details
Dunlap JJ, Patterson S. Peptic ulcer disease. Gastroenterol Nurs. 2019;42(5):451-454. doi:10.1097/SGA.0000000000000478 U.S. National Library of Medicine. Botulinum toxin pyloroplasty to reduce postoperative nausea and vomiting after sleeve gastrectomy. Another method for hemostasis involves the use of buttressing materials. Several buttressing products made from different materials have been introduced into the market, including bovine pericardium (Peri-Strips Dry with Veritas, Synovis, Deerfield, IL, USA), absorbable synthetic polymer membranes (SEAMGUARD ®, Gore ®, W. L. Gore & Associates, Inc., Newark, DE, USA, or Tri-Staple™ 2.0 Reinforced Reload, Medtronic, Minneapolis, MN, USA). Many previous studies have been conducted to elucidate the efficacy of these buttressing products in preventing bleeding from staple lines and leakage from staple line disruption. Although the results from these studies were not entirely consistent, using the buttressing product along the staple line during SG appeared to reduce the incidence of staple line bleeding; its efficacy on leakage has not been clearly demonstrated [ 4, 11, 15, 16]. However, these buttressing products are not commercially available in Korea yet.Do not drink with meals. Drink 20 minutes before meals and then wait at least 20 minutes after a meal before you drink some fluids
In stable patients, less-invasive non-surgical management should be attempted. This includes a wide range of endoscopic interventions, from endoscopic stenting and direct fistula closure, to internal drainage and radiologic interventions. Adequate drainage has been the most important treatment for early leaks, and abscesses can be drained percutaneously or endoscopically. The gastric wall defect needs to be repaired either by diverting the fistula or by direct closure. Endoscopic intervention depends on the size and characteristics of the defect [ 22]. Abdel-Sater R. Marriage dissolution in the United States: A survival analysis approach. J Divorce Remarriage. 2022;63(4):235-61. doi:10.1080/10502556.2022.2042788 The texture progression phases from fluids to solids are important to reduce the risk of unpleasant side effects such as nausea, vomiting, pain and discomfort. The gradual texture progression also helps to avoid damage to your new stomach, allows your wounds to heal after surgery and allows food to pass easily from the stomach to your small intestine. It is important not to skip any of the stages. Abdominal CT after contrast swallow in a patient with a sleeve leak. Disruption of the staple lines (a), extralumination of the contrast medium to the left subphrenic area (b, c), reactive pleural effusion (d).Once you have completed the puree stage you can move onto soft foods. It is important to follow this stage as your stomach is still healing and recovering from surgery. What is soft food? You may experience changes as your body reacts to the rapid weight loss in the first three to six months after sleeve gastrectomy, including: Li L, Wu LT. Substance use after bariatric surgery: A review. J Psychiatr Res. 2016;76:16-29. doi:10.1016/j.jpsychires.2016.01.009
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