Omentopexy Effect on Gastric Dilatation Post Laparoscopic Sleeve Gastrectomy: A Randomized Controlled Trial

Obesity is a global health crisis. Bariatric surgeries not only induce weight loss but also help in remission of these associated medical problems. Among the various bariatric procedures, laparoscopic sleeve gastrectomy (LSG) has become the most performed procedure worldwide. However, LSG has its own adverse effects. Suboptimal clinical response and recurrent weight gain are among the most challenging sequelae after surgery. Omentopexy is a novel step added to the conventional LSG. Our study aimed to assess the effect of omentopexy on gastric sleeve dilation following LSG and its impact on weight loss after surgery. This study included 100 patients who were recruited for LSG divided into 2 groups. Patients were randomly enrolled into the non-omentopexy group (underwent LSG without omentopexy) and the omentopexy group (underwent LSG with omentopexy). Gastric volumetry using 3D gastric computed tomography were done for all patients at Day 1, 6 month and 1 year after the operation. There was no significant difference between the 2 groups at postoperative Day 1 (p = 0.12) regarding the sleeve volumetry. However, after 6 months and 12 months, the non-omentopexy group showed significantly greater volume increase (p < 0.001), there was no significant correlation between gastric sleeve volume and the EWL% and TWL% in Non-omentopexy and Omentopexy groups. Omentopexy step, although adds more to the operative time, but it may serve as a guard against postoperative sleeve dilation by stabilizing the staple line which can be a major role in maintaining sufficient weight loss and prevents recurrent weight gain on the long term. LSG has become the most performed bariatric procedure worldwide. Recurrent weight gain is among the most challenging sequelae after LSG. Omentopexy fixes the sleeved stomach to the greater omentum. Omentopexy may stabilize the staple line and prevent postoperative sleeve dilation.