Background: Revisional sleeve gastrectomy has higher complications like bleeding and leakage so staple line reinforcement (SLR) is very important to decrease such dangerous events.

Purpose: The purpose of this research is to investigate the effectiveness of utilizing barbed suture to strengthen the staple line during revisional laparoscopic sleeve gastrectomy performed following an unsuccessful laparoscopic adjustable gastric band procedure.

Patients and methods: Patients were arranged into; group (A); 21 cases; underwent Laparoscopic Sleeve Gastrectomy (LSG) with stapler line strengthening by barbed suture and group (B); 21 cases; underwent LSG without strengthening. patient follow-up period was 6 months.

Results: There was no mortality. No significant differences between both groups as regard to preoperative data and hospital stay. Group (A) was performed in longer time; 109 ± 2.3 vs 78 ± 1.4 in group (B). Postoperative leak was reported only in group (B);2 patients (4.8%) and frequency of bleeding was more in group (B); 4 patients (9.6%) P-value for leak and bleeding was 0.037 & 0.048.

Conclusions: Revisional Sleeve gastrectomy by laparoscopy is still safer and minimally invasive procedure. Adding barbed suture reinforcement of the staple line is a weapon to decrease incidence of postoperative leak and bleeding to a great extent.