The Surgical Technique of Stapleless Laparoscopic One-Anastomosis Gastric Bypass with an Uncut Pouch Creation: A Randomized Clinical Trial

Background: The purpose of this study was to evaluate a stapleless and staple use surgical technique for gastric bypass. Methods: Group 1 (n = 20) included patients who had stapleless one-anastomosis gastric bypass. The patients in group 2 (n = 20) underwent one-anastomosis gastric bypass with stapler use. Results: The duration of the bypass procedure was 74.68 +/- 21.71 min for group 1, versus 85.5 +/- 19.2 min for group 2 (p = 0.051). The patients were discharged postoperatively on day 2.88 +/- 1.77 for group 1, and day 3.57 +/- 1.18 for group 2 (p = 0.04). The change in body mass index (Delta BMI) for both groups 1 and 2 at 12 months postoperative showed good results: a decrease of 12.13 (8.34-15.93) and 16.04 (11.7-20.37) from baseline, respectively (p = 0001). No mortality or serious complications were observed in either group. When comparing the number of adverse events, the difference was not significant (p = 0.07, chi(2) = 3.13). Bile reflux was nonsurgical treated with a dietary recommendation. Conclusion: Both gastric bypass procedures significantly reduced weight, however, the stapleless method is 62.78% cheaper. The safety and duration of efficacy can be discussed after longer follow-up studies. Trial registration: ClinicalTrials.gov, NCT03667469.