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Page 4 of 7 Aktokmakyan et al. Mini-invasive Surg 2020;4:23 I http://dx.doi.org/10.20517/2574-1225.2019.72

Figure 5. The stapler fired cranially

Figure 6. The gastric tube and the drain

During the transaction, clips are applied only to the staple joints and bleeding foci. Otherwise, no staple
line reinforcement technique is used. If the twist is suspected, omentoplasty can be performed from three
points as the antrum, incisura angularis, and its superior via suturing one by one. Methylene blue test is
routinely applied to test for leakage. The resected stomach is removed from the left quadrant via a 12-mm
trocar and a drain is placed from the right quadrant from a 15-mm trocar near the staple line [Figure 6].
All incisions are sutured after removing all trocars.

RESULTS
Patients are hospitalized approximately 2-4 days. On Postoperative Day 2, methylene blue test is done for
leakage. According to the negative test, the regimen is started with water, tea, and soup. After adequate
tolerance of oral fluids, the patient is discharged after the drainage catheter is removed. For the first two
weeks, juicy foods are recommended; in the following two weeks, soft foods are recommended. According
to tolerance, after the first month, solid food is started with the recommendation of less and frequent
eating.

DISCUSSION
The number of sleeve gastrectomy procedures performed increases annually. This is clarified by the
advantages of the simpler and faster technique; no malabsorption, anastomosis, or mesenteric surgery; no
[7]
foreign body being inserted; and patients rarely having symptoms of “dumping syndrome” . In a consensus
conference in 2014, LSG was accepted as a standalone procedure that reduces appetite and creates a