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Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy

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Abstract

Background

LSG has been increasingly performed. Long-term follow-up is necessary.

Methods

During the Fourth International Consensus Summit on LSG in New York Dec. 2012, an online questionnaire (SurveyMonkey®) was filled out by 130 surgeons experienced in LSG. The survey was submitted directly to the statisticians.

Results

The 130 surgeons performed 354.9 ± SD 453 LSGs/surgeon (median 175), for a total of 46,133 LSGs. The LSGs had been performed over 4.9 ± 2.7 year (range 1–10). Of the 46,133 LSGs, 0.2 ± 1.0 % (median 0, range 0–10 %) were converted to an open operation. LSG was intended as the sole operation in 93.1 ± 14.8 %; in 3.0 ± 6.3 %, a second stage became necessary. Of the 130 surgeons, 40 (32 %) use a 36F bougie, which was most common (range 32–50F). Staple-line is reinforced by 79 %; of these, 57 % use a buttress and 43 % over-sew. Mean %EWL at year 1 was 59.3 %; year 2, 59.0 %; year 3, 54.7 %; year 4, 52.3 %; year 5, 52.4 %; and year 6, 50.6 %. If a second-stage operation becomes necessary, preference was: RYGB 46 %, duodenal switch 24 %, re-sleeve 20 %, single-anastomosis duodenoileal bypass 3 %, sleeve plication 3 %, minigastric bypass 3 %, non-adjustable band 2 %, and side-to-side jejunoileal anastomosis 1 %. Complications were: high leak 1.1 %, hemorrhage 1.8 %, and stenosis at lower sleeve 0.9 %. Postoperative gastroesophageal reflux occurred in 7.9 ± 8.2 % but was variable (0–30 %). Mortality was 0.33 ± 1.6 %, which translates to ∼152 deaths. Eighty-nine percent order multivitamins (including vitamin D, calcium, and iron) and 72 % order B12. A PPI is ordered by 29 % for 1 month, 29 % for 3 months, and others for 1–12 months depending on the case.

Conclusions

LSG was relatively safe. Further long-term surveillance is necessary.

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Conflict of Interest

Mervyn Deitel, Ann L. Erickson and Ross D. Crosby have nothing to disclose. Michel Gagner is a consultant for Ethicon EndoSurgery, Covidien, Gore, MID, and Transenterix.

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Authors and Affiliations

  1. Clinical Professor of Surgery, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA

    Michel Gagner

  2. Bariatric and Metabolic Surgery, HGH, Doha, Qatar

    Michel Gagner

  3. Hopital du Sacre Coeur, Montreal, QC, Canada

    Michel Gagner

  4. Editor-in-Chief Emeritus and Founding Editor, Obesity Surgery, 39 Bassano Road, Toronto, ON, M2N 2J9, Canada

    Mervyn Deitel

  5. Statistics Department, Neuropsychiatric Research Institute, Fargo, ND, USA

    Ann L. Erickson

  6. Department of Biomedical Statistics, Neuropsychiatric Research Institute, Fargo, ND, USA

    Ross D. Crosby

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  1. Michel Gagner
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Correspondence to Mervyn Deitel.

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Gagner, M., Deitel, M., Erickson, A.L. et al. Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. OBES SURG 23, 2013–2017 (2013). https://doi.org/10.1007/s11695-013-1040-x

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