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This prospective randomized study aimed to evaluate the effect of omentopexy performed during laparoscopic sleeve gastrectomy (LSG) on incisura angularis morphology, gastric emptying time, postoperative dyspeptic symptoms, and early weight loss outcomes. Patients undergoing primary LSG were randomized to either LSG with omentopexy or LSG without omentopexy. Gastric emptying was assessed using scintigraphic gastric emptying studies, and changes in incisura angularis angle were evaluated using intraoperative image analysis. Postoperative symptoms were assessed using the Short Form Leeds Dyspepsia Questionnaire.
Laparoscopic sleeve gastrectomy (LSG) is one of the most commonly performed bariatric surgical procedures worldwide. However, postoperative gastrointestinal symptoms, gastric torsion, and functional stenosis remain important concerns after surgery. Omentopexy has been proposed as a technical modification to stabilize the gastric tube and preserve anatomical alignment, but its clinical and functional effects remain controversial.
This prospective randomized controlled study was conducted to evaluate the effect of omentopexy performed during LSG on incisura angularis morphology, gastric emptying time, postoperative dyspeptic symptoms, and early weight loss outcomes. Eligible patients undergoing primary LSG were randomized into two groups: LSG with omentopexy and LSG without omentopexy.
The incisura angularis angle was evaluated using intraoperative image analysis. Gastric emptying time was assessed preoperatively and at the postoperative third month using scintigraphic gastric emptying studies (T½). Postoperative dyspeptic symptoms were evaluated using the Short Form Leeds Dyspepsia Questionnaire. Demographic, clinical, laboratory, and postoperative outcome data were prospectively recorded and compared between groups.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| LSG With Omentopexy | Experimental | Participants underwent laparoscopic sleeve gastrectomy with omentopexy. Omentopexy was performed by fixation of the greater omentum to the gastric staple line following sleeve gastrectomy. |
|
| LSG Without Omentopexy | Active Comparator | Participants underwent standard laparoscopic sleeve gastrectomy without omentopexy. |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Laparoscopic Sleeve Gastrectomy With Omentopexy | Procedure | Laparoscopic sleeve gastrectomy was performed using a standard surgical technique. In addition, omentopexy was performed by fixation of the greater omentum to the gastric staple line in order to stabilize the gastric tube anatomy. |
| Measure | Description | Time Frame |
|---|---|---|
| Change in Incisura Angularis Angle | Changes in the incisura angularis angle were evaluated using vector-based measurements obtained from intraoperative images before and after laparoscopic sleeve gastrectomy. | Preoperative and postoperative 3 months |
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Inclusion Criteria:
Exclusion Criteria:
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| Name | Affiliation | Role |
|---|---|---|
| Volkan Genç, MD | Ankara University Faculty of Medicine | Principal Investigator |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Ankara University Faculty of Medicine | Ankara | Ankara | 06100 | Turkey (Türkiye) |
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Participants were randomized in a 1:1 ratio into two parallel groups: laparoscopic sleeve gastrectomy with omentopexy and laparoscopic sleeve gastrectomy without omentopexy.
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The researcher performing the incisura angularis angle measurements was blinded to the clinical outcomes and group allocation during image analysis.
|
| Laparoscopic Sleeve Gastrectomy Without Omentopexy | Procedure | Standard laparoscopic sleeve gastrectomy was performed without omentopexy. |
|
| ID | Term |
|---|---|
| D009765 | Obesity |
| D050177 | Overweight |
| D004415 | Dyspepsia |
| ID | Term |
|---|---|
| D044343 | Overnutrition |
| D009748 | Nutrition Disorders |
| D009750 | Nutritional and Metabolic Diseases |
| D001835 | Body Weight |
| D012816 | Signs and Symptoms |
| D013568 | Pathological Conditions, Signs and Symptoms |
| D012817 | Signs and Symptoms, Digestive |
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