It is with great pleasure that we present an interview with Dr. Bruno Dillemans for sharing his extensive insights and experience in bariatric and metabolic surgery.
We extend our heartfelt gratitude to Dr. Dillemans for his invaluable contribution to this outstanding masterclass and look forward to our next gathering with all of you!

Concerns with Stapling Devices

What are the primary concerns when using stapling devices during surgery?

“ I think stapling devices have become indispensable tools for cutting organs or making connections, such as anastomoses. The advancements we've seen in laparoscopic and open surgeries wouldn't have been possible without these devices. Two critical features of stapling devices are safety and ergonomics. Safety is paramount, especially in preventing leaks during stapling or anastomosis and minimizing bleeding. Fortunately, modern devices have improved significantly compared to those in the 1990s. The other important aspect is the ease of handling the device, which affects the surgeon's dexterity.

Minimizing Bleeding Complications

How do you minimize the risk of bleeding complications during surgery?

“ We worked extensively with Professor Jan Paul Mulier, who was the chief of the Department of Anesthesiology, to improve bleeding prevention. One key strategy we implemented was maintaining a low systolic blood pressure during surgery and increasing it at the end to identify any bleeding spots. This allows us to address bleeding efficiently using clips or harmonic devices. Additionally, the evolution of stapling devices, such as moving from two rows to three rows of staples and introducing reinforcement on the cartridges, has significantly reduced the risk of both extraluminal and intraluminal bleeding.”

Experience with the Fulbright Lunar Stapler

What are your thoughts on the Fulbright Lunar Stapler in minimizing bleeding?

“ I don't have extensive experience with the Lunar stapler yet. However, from what I've observed, its compression seems effective. When we elevate the systolic blood pressure at the end of the operation, we don't see significant bleeding, indicating good performance. But I must be cautious in my assessment until I gain more experience with it.”

• First Impressions of the Lunar U

What was your first impression of the Lunar U?

“ My first impression was positive. It’s easy to handle, which is beneficial, especially for female surgeons.You can adjust the cartridges to the desired angle, which is crucial for making anastomoses, such as gastro-gastric connections. The electronic system that waits 15 seconds before firing is a helpful feature, removing the need to count manually. Overall, while my experience is still limited with it, the Lunar stapler appears to be a solid device.”

• Favorite Features of the Lunar U

What are your favorite features of the Lunar U?

“ I think the ease of handling is a significant benefit. The cartridges fit well, and the device's compression capability is impressive. You can also tailor the way you grasp it to remove stomach or tissue more effectively. These features, while small, add up to provide a competitive edge. However, more experience with the device will better define its benefits.”

Closing Remarks

Do you have any words for surgeons interested in joining your courses?

“ Thank you very much. Everybody is certainly welcome to join us on one of the bariatric courses. In my experience, many years of evolution have made our institution a bariatric surgery reference center. For those surgeons aiming to advance their skills, you are more than welcome to join us. I think it's going to be interesting, and we are always pleased to welcome everybody. Thank you."