Perioperative Practices Concerning Sleeve Gastrectomy – a Survey of 863 Surgeons with a Cumulative Experience of 520,230 Procedures
Sleeve Gastrectomy (SG) is the most commonly performed bariatric procedure worldwide. There is currently no scientific study aimed at understanding variations in practices concerning this procedure. The aim of this study was to study the global variations in perioperative practices concerning SG.
A 37-item questionnaire-based survey was conducted to capture the perioperative practices of the global community of bariatric surgeons. Data were analyzed using descriptive statistics.
Response of 863 bariatric surgeons from 67 countries with a cumulative experience of 520,230 SGs were recorded. A total of 689 (80%) and 764 (89%) surgeons listed 13 absolute and relative contraindications, respectively. 65% (n = 559) surgeons perform routine preoperative endoscopy and 97% (n = 835) routinely use intraoperative orogastric tube for sizing the resection. A wide variation is observed in the diameter of the tube used. 73% (n = 627) surgeons start dividing the stomach at a distance of 3–5 cm from the pylorus, and 54% (n = 467) routinely use staple line reinforcement. Majority (65%, n = 565) of surgeons perform routine intraoperative leak test at the end of the procedure, while 25% (n = 218) surgeons perform a routine contrast study in the early postoperative period. Lifelong multivitamin/mineral, iron, vitamin D, calcium, and vitamin B12 supplementation is advocated by 66%, 29%, 40%, 38% and 44% surgeons, respectively.
There is a considerable variation in the perioperative practices concerning SG. Data can help in identifying areas for future consensus building and more focussed studies.
KeywordsSleeve gastrectomy Perioperative practices Survey research
M.T.A is grateful to Mr. A. Munasinghe, Mr. O. Al-taan, Mr. F. Rashid, Mr. V. Jain, Mr. D. Whitelaw and Mr. P. Jambulingam for the support and help he received in carrying out this research.
K.M. and M.T.A. conceived the idea. M.T.A. and K.M. drafted the initial questionnaire. All other authors contributed to the survey design. All authors were responsible for the distribution of the survey link. M.T.A wrote the manuscript with help from KM. All other authors contributed to the manuscript and approved the final draft.
Compliance with Ethical Standards
Conflict of Interest
K.M. has been paid honoraria by Medtronic, Gore and Olympus for educational activities, outside the submitted work. All other authors do not declare any Conflict of Interest.
- 1.4th IFSO Global Registry Report. The IFSO global registry. 2018. Available at https://www.ncbi.nlm.nih.gov/pubmed/30121858. Last accessed on 31 July 2019.
- 13.Kelley K, Clark B, Brown V, et al. Good practice in the conduct and reporting of survey research. Int J Qual Health Care. 2003;15(3):261–6. Available from https://www.equator-network.org/reporting-guidelines/good-practice-in-the-conduct-and-reporting-of-survey-research/ CrossRefGoogle Scholar
- 21.Berger ER, Clements RH, Morton JM, et al. The impact of different surgical techniques on outcomes in laparoscopic sleeve Gastrectomies: the first report from the metabolic and bariatric surgery accreditation and quality improvement program (MBSAQIP). Ann Surg. 2016;264(3):464–73.CrossRefGoogle Scholar