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2026, Number 1-2

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Rev Mex Cir Endoscop 2026; 27 (1-2)

Inadvertent stapling of the orogastric tube in laparoscopic sleeve gastrectomy. Clinical case

Guzmán-Esquivel H, Arenas-Padilla JA, Pérez-Basurto MS

Language: Spanish
References: 17
Page: 39-43
PDF size: 877.29 Kb.


ABSTRACT

Introduction: laparoscopic sleeve gastrectomy is the most common bariatric procedure worldwide. However, unusual events such as accidental stapling of intraluminal devices can occur and are underreported in the literature. Although rare, these complications carry a high risk of gastric leakage and require specialized interventions to prevent significant morbidity. Clinical case: a 40-year-old male patient with morbid obesity (BMI 40.1) and type 2 diabetes mellitus underwent laparoscopic sleeve gastrectomy. During gastric stapling with a 39 Fr calibration bougie, accidental stapling of the bougie in the gastric fundus was identified. The affected segment was resected, airtightness was confirmed by endoscopy, and reinforcement with sutures was performed. The initial postoperative course was favorable; however, the patient was readmitted due to abdominal pain and tachycardia. A CT scan revealed a left subphrenic collection. He was managed conservatively with fasting, antibiotics, and enteral nutrition. At 20 months follow-up, the patient showed satisfactory progress with 32% weight loss. Conclusion: accidental stapling of the bougie is a rare but serious complication. Early detection and prompt surgical treatment, combined with comprehensive postoperative management, are essential to prevent major sequelae and ensure favorable clinical outcomes.


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