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Introduction: Staple line oversewing (SLO) is a prophylactic alternative due to its low cost and its effect of decreasing the incidence and severity of bleeding complications in sleeve gastrectomy (SG). However, this approach significantly increases the surgical time and may be associated with stenosis. The study aims to identify whether its usage was sufficient to optimize the surgical time in patients whose screening for the risk of occult bleeding was negative. Materials and Methods: The study enrolled 103 patients. Having the systolic blood pressure goal of 140 mmHg, the staple line is checked for bleeding points, counting as follows: >5 bleeding points proceed to SLO, <5 bleeding points are managed using clips, and if no bleeding points are found, the procedure can be completed. Results: The bleeding test was positive in 79.6% of the cases and oversewing was necessary for 44.7% of the total. The bleeding test result was significant for the increased surgical time. The mean surgical time in SLO was 16.4% higher than in clipping. There was a significant difference in surgical time between SLO and clipping; however, no significant difference was identified between clipping and continuing the procedure without further measures. No postoperative complication related to staple line bleeding was identified. Discussion: In a scenario with limitations for the use of high-cost homeostatic agents, the stratified protocol to prevent bleeding in SG stapling line was able to significantly reduce surgical time without significant added risks. Conclusion: A stratified protocol to prevent bleeding in SG stapling line was able to significantly reduce surgical time. [ABSTRACT FROM AUTHOR]

Introduction: To assess the practical knowledge, interest, and training levels of surgeons enrolled in the Brazilian College of Surgeons (CBC) of the municipality of Porto Alegre, Rio Grande do Sul, regarding robotic surgery. Methods: Cross-sectional study, based on information collected with a questionnaire sent to potential participants via digital platform. The form contained structured and self-administered questions, to characterize their professional profile, skills in minimally invasive surgery, knowledge, opinion, and specific training in robotic surgery. Results: Of the 146 members enrolled in the CBC of the municipality of Porto Alegre, 99 (67.8%) responded to the questionnaire. Most were males (88%) with a mean age of 48 years. Video-laparoscopic or video-assisted procedures were the most frequent in the participants' practice. Of the sample, most (78%) already watched at least one robotic surgery, and one third (n = 30) had already completed some sort of training or simulation course in robotic surgery. Among those who did not, two thirds intend to pursue formal training in the future. Only 10% of participating surgeons are certified in the area. Conclusion: Most responding surgeons enrolled in the CBC in Porto Alegre perform mostly minimally invasive procedures daily and believe that the robotic technology will be the future of surgery. Although not yet available in most services of the state of Rio Grande do Sul, it is expected that the development of new platforms and the reduction of costs involved in equipment acquisition and surgical training will facilitate the dissemination of this technology. [ABSTRACT FROM AUTHOR]

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