الفهرس 
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Abstract
Laparoscopic sleeve gastrectomy (LSG) is becoming a popular restrictive procedure for morbid obesity. Complications varies between postoperative bleeding, appearance of gastric leak, development of gastroesophageal reflux disease (GERD), appearance of stricture, dilation of the gastric tube, and insufficient weight loss. The main complications in the early postoperative course are postoperative bleeding and the appearance of a gastric leak. Bleeding can occur along the staple line as well as along the greater omentum which has been freed from the greater curvature, allowing the resection of the fundus and body of the stomach.
Sometimes, this complication cannot be treated conservatively, and the patient has to go back to the operative theatre for revision. The appearance of a leak after LSG is related to the tubulization of the stomach with a long vertical staple line going from the antrum to the gastroesophageal junction.
Typically, after LSG, leaks appear just below the gastroesophageal junction because of the high internal pressure created with the vertical tubulization of the stomach .Management of the leak is difficult, with longer hospital stay, and quite often demanding placement of endoscopic stents.
Management of the staple line is actually not well standardized. Three options are available: no staple line reinforcement, buttressing the staple line with specific bio absorbable material, and Imbrication of the Staple line.
Buttressing the staple line can be performed using glycolidetrimethylene carbonate copolymer (Gore Seamguard®; W.L.Gore & Associates, Inc, Flagstaff, AZ) , or bovine pericardium strips (Peristrips Dry and PSD Veritas; Synovis Surgical Innovations, St Paul, MN) ,or porcine small intestinal submucosa (Surgisis Biodesign, Cook Medical, Inc, Bloomington, IN).
In the current study we aimed to determine the effect of reinforcement of whole staple line by imbrication using continous seromuscular invagination suture. Regarding bleeding, leakage, length of hospital stay, readmission, reoperation rates and stricture rates.