One of the potential risks of Roux en Y Gastric Bypass and the Sleeve Gastrectomy is a staple line leak. Here, you’ll learn more about why and how these occur, what they mean, and what is the likelihood of developing this complication.
A staple line leak is an internal leak or opening that can occur along any of the staple lines of a Roux En Y Gastric Bypass or a Sleeve Gastrectomy. The risk of developing a leak in a Roux En Y Gastric Bypass is approximately 1%. The risk of developing a leak in a Sleeve Gastrectomy is approximately 0.5%. A leak may result in needing more surgeries, revisions, and prolonged hospitalization with rehabilitation.
In a Roux En Y Gastric bypass, when the surgeon attaches the small intestine to the large intestine or the small intestine to the stomach, the connection is called an anastomosis. In both a Sleeve Gastrectomy and a Roux En Y Gastric Bypass, staples are used as a temporary “glue” to create a watertight connection of these surgical areas. Then, over time, the body’s healing power takes over for the staples to create a seal over the staples. If the body’s healing power does not form a complete seal, or if the staples come apart (dehisce), then leakage of fluid from within the bowel or stomach occurs and it is called a staple line leak. This is one of the more serious potential risks of Sleeve Gastrectomy and Roux En Y Gastric Bypass surgery. Fluid from the GI tract that contains bacteria, then leaks into the abdomen (where it doesn’t belong), and can cause a serious infection which is accompanied by much swelling, a rapid pulse rate, fevers, and sometimes can form an abscess. This complication, although quite rare, is always a very serious one.
Most would think that an immediate operation is required to seal the leak and drain away the infection. There are certain cases where this may be necessary but sometimes an interventional radiologist can perform the drainage without the need for surgery. When this is possible, the insult of surgery, as well as the spreading of infection into the rest of the abdomen, can be avoided.