{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T18:40:01Z","timestamp":1746902401776,"version":"3.40.5"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"5","license":[{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T00:00:00Z","timestamp":1744588800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["OBES SURG"],"published-print":{"date-parts":[[2025,5]]},"abstract":"<jats:title>Abstract<\/jats:title>\n          <jats:sec>\n            <jats:title>Background<\/jats:title>\n            <jats:p>Laparoscopic sleeve gastrectomy (LSG) accounts for the majority of weight loss surgeries worldwide. Although the overall side effect profile is low, the rate of <jats:italic>de novo<\/jats:italic> gastroesophageal reflux disease (GERD) ranges between 2.1 and 49%. Our study compares postoperative outcomes using a single-fire stapler versus a multiple-fire linear stapler, with a focus on postoperative <jats:italic>de novo<\/jats:italic> GERD.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods<\/jats:title>\n            <jats:p>This was a retrospective single-surgeon study with data from 257 patients who underwent consecutive robotic-assisted sleeve gastrectomy between 2016 and 2023 with either multiple fires of a linear stapler (<jats:italic>n<\/jats:italic>\u2009= 201) or a single-fire linear stapler (<jats:italic>n<\/jats:italic>\u2009= 56). Patient demographics and postoperative outcomes, including 30-day complications, 1-year weight loss, and 1-year postoperative reflux, were analyzed.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results<\/jats:title>\n            <jats:p>Patients in the single-fire group were noted to have a significantly lower rate of postoperative reflux (7.1% vs. 26.4%) and a decreased incidence of <jats:italic>de novo<\/jats:italic> reflux (1.8% vs. 10.9%). Additionally, the single-fire group had a shorter average length of stay (2.0 days vs. 2.2 days, <jats:italic>p<\/jats:italic>\u2009= 0.04). Multivariable analysis demonstrated that single-fire stapler use increased the likelihood of not developing postoperative GERD (odds ratio: 8.4, 95% confidence interval: 2.8\u201332.5). There was no significant difference in operative time (multiple-fire group: 81.4 min, single-fire group: 90.1 min, <jats:italic>p<\/jats:italic>\u2009= 0.5) or 1-year percent total weight loss (multiple-fire: 22.4% \u00b1\u20090.7%, single-fire: 22.0% \u00b1\u20091.7%, <jats:italic>p<\/jats:italic>\u2009= 0.8).<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions<\/jats:title>\n            <jats:p>Single-fire stapler use may enhance postoperative outcomes in LSG by reducing rates of <jats:italic>de novo<\/jats:italic> GERD without impacting weight loss. There was no significant difference in operative time, and postoperative length of stay may be decreased.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1007\/s11695-025-07855-z","type":"journal-article","created":{"date-parts":[[2025,4,14]],"date-time":"2025-04-14T04:01:57Z","timestamp":1744603317000},"page":"1838-1844","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Does Stapling Platform Influence Robotic Sleeve Gastrectomy Postoperative Outcomes?"],"prefix":"10.1007","volume":"35","author":[{"given":"Lee","family":"Ying","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Rachael","family":"Rutledge","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Samuel","family":"Butensky","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel Farinas","family":"Lugo","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John","family":"Morton","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Forrest","family":"Ringold","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2025,4,14]]},"reference":[{"key":"7855_CR1","unstructured":"Obesity and Overweight. World Health Organization. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/obesity-and-overweight. 2024. Accessed August 8, 2024."},{"key":"7855_CR2","doi-asserted-by":"publisher","first-page":"1822","DOI":"10.1007\/s11695-015-1657-z","volume":"25","author":"L Angrisani","year":"2015","unstructured":"Angrisani L, Santonicola A, Iovino P, et al. Bariatric surgery worldwide 2013. Obes Surg. 2015;25:1822\u201332.","journal-title":"Obes Surg"},{"key":"7855_CR3","doi-asserted-by":"publisher","first-page":"741097","DOI":"10.1155\/2013\/741097","volume":"2013","author":"M Laffin","year":"2013","unstructured":"Laffin M, Chau J, Gill RS, et al. Sleeve gastrectomy and gastroesophageal reflux disease. J Obes. 2013;2013:741097.","journal-title":"J Obes"},{"key":"7855_CR4","unstructured":"Antunes C, Aleem A, Curtis SA. Gastroesophageal reflux disease. In: Statpearls. 2024. Available from: https:\/\/www.ncbi.nlm.nih.gov\/books\/NBK441938\/. 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Prevalence and risk factors for bariatric surgery readmissions: findings from 130,007 admissions in the metabolic and bariatric surgery accreditation and quality improvement program. Ann Surg. 2018;267:122\u201331.","journal-title":"Ann Surg"},{"key":"7855_CR8","doi-asserted-by":"publisher","first-page":"6285","DOI":"10.1007\/s00464-022-09051-x","volume":"36","author":"CE Salyer","year":"2022","unstructured":"Salyer CE, Thompson J, Hoffman A, et al. Multisite study of Titan SGS stapler in longitudinal gastric resection. Surg Endosc. 2022;36:6285\u201392.","journal-title":"Surg Endosc"},{"key":"7855_CR9","unstructured":"UPDATE: safe use of surgical staplers and staples - letter to health care providers. U.S. Food and drug administration. 2021. Available from: https:\/\/public4.pagefreezer.com\/content\/FDA\/21-02-2024T12:58\/https:\/www.fda.gov\/medical-devices\/letters-health-care-providers\/update-safe-use-surgical-staplers-and-staples-letter-health-care-providers. Accessed October 6, 2024."},{"key":"7855_CR10","doi-asserted-by":"crossref","unstructured":"Toro JP, Lin E, Patel AD, et al. Association of radiographic morphology with early gastroesophageal reflux disease and satiety control after sleeve gastrectomy. J Am Coll Surg. 2014;219. Available from: https:\/\/journals.lww.com\/journalacs\/fulltext\/2014\/09000\/association_of_radiographic_morphology_with_early.11.aspx. Accessed Apr 2025.","DOI":"10.1016\/j.jamcollsurg.2014.02.036"},{"key":"7855_CR11","doi-asserted-by":"publisher","first-page":"3553","DOI":"10.1007\/s11695-024-07357-4","volume":"34","author":"GD Fritz","year":"2024","unstructured":"Fritz GD, Sharrak A, Aubrey J, et al. Perioperative outcomes using single-fire stapler. Obes Surg. 2024;34:3553\u201360.","journal-title":"Obes Surg"},{"key":"7855_CR12","doi-asserted-by":"publisher","first-page":"1627","DOI":"10.3748\/wjg.v22.i4.1627","volume":"22","author":"A Khan","year":"2016","unstructured":"Khan A, Kim A, Sanossian C, et al. Impact of obesity treatment on gastroesophageal reflux disease. World J Gastroenterol. 2016;22:1627\u201338.","journal-title":"World J Gastroenterol"},{"key":"7855_CR13","doi-asserted-by":"publisher","unstructured":"Collins TC, Daley J, Henderson WH, et al. Risk factors for prolonged length of stay after major elective surgery. Ann Surg. 1999. https:\/\/doi.org\/10.1097\/00000658-199908000-00016. (Epub ahead of print).","DOI":"10.1097\/00000658-199908000-00016"},{"key":"7855_CR14","doi-asserted-by":"publisher","first-page":"211","DOI":"10.1159\/000538399","volume":"42","author":"P Kahrilas","year":"2024","unstructured":"Kahrilas P, Anastasiou F, Bredenoord AJ, et al. Proton pump inhibitors: rational use and use-reduction - the windsor workshop. Dig Dis. 2024;42:211\u201320.","journal-title":"Dig Dis"},{"key":"7855_CR15","first-page":"1360","volume":"10","author":"P Bytzer","year":"2012","unstructured":"Bytzer P, Jones R, Vakil N, et al. Limited ability of the proton-pump inhibitor test to identify patients with gastroesophageal reflux disease. Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc. 2012;10:1360\u20136.","journal-title":"Clin Gastroenterol Hepatol Off Clin Pract J Am Gastroenterol Assoc"}],"container-title":["Obesity Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-025-07855-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s11695-025-07855-z\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s11695-025-07855-z.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,5,10]],"date-time":"2025-05-10T18:18:19Z","timestamp":1746901099000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s11695-025-07855-z"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,4,14]]},"references-count":15,"journal-issue":{"issue":"5","published-print":{"date-parts":[[2025,5]]}},"alternative-id":["7855"],"URL":"https:\/\/doi.org\/10.1007\/s11695-025-07855-z","relation":{},"ISSN":["0960-8923","1708-0428"],"issn-type":[{"type":"print","value":"0960-8923"},{"type":"electronic","value":"1708-0428"}],"subject":[],"published":{"date-parts":[[2025,4,14]]},"assertion":[{"value":"19 October 2024","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"11 March 2025","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"4 April 2025","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"14 April 2025","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"Dr. Lee Ying, Ms. Rachael Rutledge, Dr. Samuel Butensky, and Dr. Daniel Farinas Lugo declare no financial interests. Dr. John Morton has received consulting fees from Johnson and Johnson\u00ae, Novo Nordisk\u00ae, Olympus\u00ae, and Teleflex\u00ae. Dr. Forrest Ringold is a proctor for Intuitive\u00ae, is on the company\u2019s speakers\u2019 bureau, owns Intuitive Surgical stock\u00ae, and has received consulting fees from Teleflex\u00ae.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing interests"}}]}}