Watch as Bariatric Surgeon, Gregory Schroder, M.D., performs a minimally invasive sleeve gastrectomy using the Titan SGS stapler to create the sleeve. This approach results in less nausea, vomiting, and reflux post-surgery.
Hello. My name is Gregory Schroeder and I'm one of the bariatric surgeons at Center Comprehensive Weight Loss Solutions. Today, we're gonna discuss the sleeve gastrectomy using the Titan Sgs stapler to perform a sleeve gastrectomy or what we refer to as the standard sleeve. The standard sleeve gastrectomy is performed minimally invasively using cars or laparoscopic equipment to access the abdomen and do the surgery. We enter the abdomen. And our goals are to take a volleyball shaped stomach down to the size of a banana using the titan sts stapler. Our goals are to create a smaller stomach. So the patients eat less, get full quicker, stay full longer and lose up to 65 to 70% of their excess weight and maintain that. A special instrument called a harmonic scalpel is used to free up the stomach and all of its attachments on the greater curvature of the stomach or the longer side of the stomach. This harmonic is a ultrasound guided instrument that denatures protein and cuts the tissue as well as causes it to be hemostatic. So it doesn't bleed. Once we've completely mobilized the stomach, we will get the stomach ready to put through the stapler, but we have to get all the attachments all the way up to the ge junction and left cruise to put the stapler in and perform the surgery. Once we have the stomach completely freed up, we measure certain landmarks. Six centimeters from the pylorus, approximately three centimeters from the incisura and one centimeter from the ge junction creating a perfect 10 sleeve gastrectomy. Next, we introduce the titan SGS stapler and open it to place the stomach into the stapler. What this does is allow a single firing to create the sleeve instead of using multiple firings of another stapler to create the sleeve allowing for variability in the size of the stomach. Variability in the shape, multiple firings of a stapler can lead to staple malformation, narrowing of the sleeve and even malformation of the new stomach. It's not reproducible and it's not standardized using the standard theatrics SGS Titan stapler. We are able to position the stomach over a boujee place the stomach at the marks that we've already created at one centimeter three centimeters and six centimeters close the stapler with the bougie in place to ensure that the sleeve is created reproducible in a standard way without any kinks, malformation or other complications. The staples are graduated to the thickness of the uh stomach and the firing is done in one firing taking approximately 55 seconds. Once the firing is complete, the stomach excess stomach is removed and the stapler is closed and removed from the abdomen. And what you see is a final product that is reproducible and consistent and allows for less nausea, vomiting, post op and also less reflux. In this part of the procedure, we are stabilizing the sleeve by sewing back the short gastric vessels to the sleeve to prevent it from kinking, twisting or causing any type of obstruction. The surgery itself takes approximately 30 to 45 minutes and it's very comparable to doing a laparoscopic cholecystectomy or taking out your gallbladder laparoscopically, the specimen is removed. You have 35 millimeter trochar and 1 19 millimeter trocar and that concludes the procedure.