Sleeve gastrectomy, commonly known as a gastric sleeve, is a restrictive bariatric surgery performed to limit food intake and promote significant weight loss. The procedure involves removing a substantial portion of the stomach to create a narrow, tube-shaped pouch. A frequent question concerns the metallic fasteners used to seal the new stomach: do these gastric sleeve staples dissolve, or do they remain in the body forever? This article addresses the permanence of the surgical staples and clarifies the purpose of all materials used along the stomach’s new seam.
The Composition and Permanence of Gastric Sleeve Staples
The staples used in a sleeve gastrectomy are designed to be permanent. These surgical fasteners are typically made from medical-grade titanium, a material chosen for its strength, corrosion resistance, and high biocompatibility. Titanium is non-reactive, meaning it does not cause allergic reactions or significant irritation within the body’s tissues.
The function of these staples is to create a permanent, tight seal along the newly formed stomach sleeve. Specialized stapling devices deploy multiple rows of tiny, “B”-shaped fasteners. They hold the divided edges of the stomach tissue together until the body’s natural healing process creates a permanent biological seal. The non-dissolving nature of the titanium provides long-term structural support for the reshaped stomach.
Clarifying Dissolvable Materials Used in Staple Line Reinforcement
The confusion about staples dissolving often arises because surgeons frequently use absorbable materials to reinforce the staple line. These reinforcement techniques, such as oversewing the staple line with sutures or applying buttressing material, provide additional support against bleeding and leakage immediately after the procedure.
Surgeons may use absorbable sutures or synthetic buttressing membranes made from materials like polyglycolic acid. These materials are designed to be temporary, providing extra strength during the first few weeks of healing while the stomach tissue fuses. The buttressing material or absorbable suture lines will gradually break down and be absorbed by the body over several weeks or months. The underlying titanium staples, however, do not dissolve and remain embedded in the stomach wall.
The Long-Term Fate of Permanent Staples in the Body
The permanent titanium staples are biologically inert, meaning they do not degrade or react with the surrounding tissues. Once the stomach tissue has fully healed and fused, the body begins a process of tissue integration around each staple. This involves the formation of a layer of scar tissue that encapsulates the staples, effectively incorporating them into the stomach wall.
Because titanium is non-magnetic, the presence of these staples does not interfere with medical imaging procedures like Magnetic Resonance Imaging (MRI) scans. Patients with a gastric sleeve can safely undergo MRIs without concern for the staples shifting or causing adverse effects. They are intended to stay in place without causing pain or requiring removal.
Identifying and Managing Staple Line Complications
While the staples are designed for permanent safety, the staple line itself can rarely be the site of complications following a sleeve gastrectomy. The two primary concerns are staple line leakage and stricture. Leakage occurs when the seal fails, allowing gastric content to escape into the abdominal cavity. This typically happens within the first few weeks after surgery.
Symptoms of a leak can include severe abdominal pain, a rapid heart rate (tachycardia), fever, and persistent hiccups. Early diagnosis is crucial, often involving a CT scan or endoscopy. Management can range from drainage and nutritional support to stent placement, which seals the leak from the inside.
Stricture (Stenosis)
Stricture, or stenosis, involves a narrowing of the stomach sleeve, which usually develops more slowly over time. This complication is often located near the lower portion of the sleeve. Patients with a stricture experience difficulty swallowing, persistent vomiting, and an inability to tolerate solid foods. Treatment typically involves endoscopic dilation, where a balloon is inserted via an endoscope and gradually inflated to stretch the narrowed segment of the stomach.