Unveiling Unforeseen Challenges: A case report on stapling and entrapment of Nasogastric tube in laparoscopic sleeve gastrectomy.”

Unveiling Unforseen Challenges: A case report on stapling and entrapement of Nasogastric tube in laparoscopic sleeve gastrectomy.”

Abstract

Laparoscopic sleeve gastrectomy is removal of vast majority of the stomach especially the fundus, leaving only a thin gastric tube between the esophagus and the duodenum. Sleeve gastrectomy, one of the most popular bariatric surgeries in the modern era, that is easiest to learn and maintains the normal physiological continuity of gut. Complications inherent to surgical procedures can often be averted through vigilant adherence to checkpoints. We report a complication involving the stapling and entrapment of a nasogastric tube (NGT) during laparoscopic sleeve gastrectomy in a 45-year-old lady with severe obesity (BMI 42.1 kg/m²). Despite multiple unsuccessful attempts to remove the NG tube post-surgery, subsequent examination of the resected specimen in the pathology lab revealed a portion of the NG tube embedded in the staple line. Hence the part of NG tube caught up in the staple line was confirmed. Patient underwent relaparoscopy and a retained part of NG tube was successfully removed. She recovered well and was discharged on 4th post operative day. Since the saying goes; sharing is learning, we report this case for fostering awareness among colleagues to prevent encountering similar challenges, particularly given the prevalent use of staplers in contemporary surgical practices.