What is a leak test, and should I have one?
One of the most feared causes of complications after sleeve gastrectomy is a leak at the staple line. These leaks can be caused either by stapler malfunction, wrong choice of stapler size, or trying to staple tissue too thick to accomodate the stapler. There are several ways to test a staple line for defects. One is to submerge the finished sleeve under saline solution and inflate it with air from either a tube or an endoscope in the stomach. Another is to pump a dye called methylene blue into the stomach and see if it leaks out. These tests are done during the surgery. After surgery, we can test for leaks by giving contrast material (dye) by mouth and taking x-ray pictures to look for a leak. Each test has advantages and disadvantages, as well as significant false negative rates (the test is normal but there is still a leak). Another problem comes from the fact that many leaks don’t even turn up until several days to a week after the surgery. Each surgeon has his own technique and phi
