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Erschienen in: Obesity Surgery 2/2020

01.11.2019 | Original Contributions

Perioperative Practices Concerning Sleeve Gastrectomy – a Survey of 863 Surgeons with a Cumulative Experience of 520,230 Procedures

verfasst von: Md Tanveer Adil, Ali Aminian, Aparna Govil Bhasker, Reynu Rajan, Ricard Corcelles, Carlos Zerrweck, Yitka Graham, Kamal Mahawar

Erschienen in: Obesity Surgery | Ausgabe 2/2020

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Abstract

Background

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.

Methods

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.

Results

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.

Conclusion

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.
Literatur
2.
Zurück zum Zitat Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8:267–82.CrossRef Hess DS, Hess DW. Biliopancreatic diversion with a duodenal switch. Obes Surg. 1998;8:267–82.CrossRef
3.
Zurück zum Zitat Scopinaro N, Gianetta E, Civalleri D, et al. Bilio-pancreatic bypass for obesity: II. Initial experience in man. Br J Surg. 1979;66:618–20.CrossRef Scopinaro N, Gianetta E, Civalleri D, et al. Bilio-pancreatic bypass for obesity: II. Initial experience in man. Br J Surg. 1979;66:618–20.CrossRef
4.
Zurück zum Zitat DeMeester TR, Fuchs KH, Ball CS, et al. Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux. Ann Surg. 1987;206:414–26.CrossRef DeMeester TR, Fuchs KH, Ball CS, et al. Experimental and clinical results with proximal end-to-end duodenojejunostomy for pathologic duodenogastric reflux. Ann Surg. 1987;206:414–26.CrossRef
5.
Zurück zum Zitat Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10:514–23.CrossRef Ren CJ, Patterson E, Gagner M. Early results of laparoscopic biliopancreatic diversion with duodenal switch: a case series of 40 consecutive patients. Obes Surg. 2000;10:514–23.CrossRef
6.
Zurück zum Zitat Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRef Cottam D, Qureshi FG, Mattar SG, et al. Laparoscopic sleeve gastrectomy as an initial weight-loss procedure for high-risk patients with morbid obesity. Surg Endosc. 2006;20:859–63.CrossRef
7.
Zurück zum Zitat Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRef Regan JP, Inabnet WB, Gagner M, et al. Early experience with two-stage laparoscopic roux-en-Y gastric bypass as an alternative in the super-super obese patient. Obes Surg. 2003;13:861–4.CrossRef
8.
Zurück zum Zitat Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15(10):1469–75.CrossRef Moon Han S, Kim WW, Oh JH. Results of laparoscopic sleeve gastrectomy (LSG) at 1 year in morbidly obese Korean patients. Obes Surg. 2005;15(10):1469–75.CrossRef
9.
Zurück zum Zitat Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12:662–7.CrossRef Tucker ON, Szomstein S, Rosenthal RJ. Indications for sleeve gastrectomy as a primary procedure for weight loss in the morbidly obese. J Gastrointest Surg. 2008;12:662–7.CrossRef
10.
Zurück zum Zitat Rosenthal RJ. International sleeve gastrectomy expert panel. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8:8–19.CrossRef Rosenthal RJ. International sleeve gastrectomy expert panel. International sleeve gastrectomy expert panel consensus statement: best practice guidelines based on experience of >12,000 cases. Surg Obes Relat Dis. 2012;8:8–19.CrossRef
11.
Zurück zum Zitat Gagner M, Hutchinson C, Rosenthal R. Fifth international consensus conference: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2016;12:750–6.CrossRef Gagner M, Hutchinson C, Rosenthal R. Fifth international consensus conference: current status of sleeve gastrectomy. Surg Obes Relat Dis. 2016;12:750–6.CrossRef
12.
Zurück zum Zitat Ferrer-Marquez M, Belda-Lozano R, Ferrer-Ayza M. Technical controversies in laparoscopic sleeve gastrectomy. Obes Surg. 2012;22:181–7.CrossRef Ferrer-Marquez M, Belda-Lozano R, Ferrer-Ayza M. Technical controversies in laparoscopic sleeve gastrectomy. Obes Surg. 2012;22:181–7.CrossRef
14.
Zurück zum Zitat Gagner M. Is sleeve gastrectomy always an absolute contraindication in patients with Barrett's? Obes Surg. 2016;26(4):715–7.CrossRef Gagner M. Is sleeve gastrectomy always an absolute contraindication in patients with Barrett's? Obes Surg. 2016;26(4):715–7.CrossRef
15.
Zurück zum Zitat Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett's esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017;13(4):568–74.CrossRef Genco A, Soricelli E, Casella G, et al. Gastroesophageal reflux disease and Barrett's esophagus after laparoscopic sleeve gastrectomy: a possible, underestimated long-term complication. Surg Obes Relat Dis. 2017;13(4):568–74.CrossRef
16.
Zurück zum Zitat Telem DA, Gould J, Pesta C, et al. American Society for Metabolic and Bariatric Surgery: care pathway development for laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(5):742–9.CrossRef Telem DA, Gould J, Pesta C, et al. American Society for Metabolic and Bariatric Surgery: care pathway development for laparoscopic sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(5):742–9.CrossRef
17.
Zurück zum Zitat Saarinen T, Kettunen U, Pietilainen KH, et al. Is preoperative gastroscopy necessary before sleeve gastrectomy and roux-en-Y gastric bypass? Surg Obes Relat Dis. 2018;14(6):757–62.CrossRef Saarinen T, Kettunen U, Pietilainen KH, et al. Is preoperative gastroscopy necessary before sleeve gastrectomy and roux-en-Y gastric bypass? Surg Obes Relat Dis. 2018;14(6):757–62.CrossRef
18.
Zurück zum Zitat Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257(2):231–7.CrossRef Parikh M, Issa R, McCrillis A, et al. Surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy: a systematic review and meta-analysis of 9991 cases. Ann Surg. 2013;257(2):231–7.CrossRef
19.
Zurück zum Zitat Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.CrossRef Gumbs AA, Gagner M, Dakin G, et al. Sleeve gastrectomy for morbid obesity. Obes Surg. 2007;17:962–9.CrossRef
20.
Zurück zum Zitat Sanchez-Santos R, Masdevall C, Baltasar A, et al. Short- and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg. 2009;19(9):1203–10.CrossRef Sanchez-Santos R, Masdevall C, Baltasar A, et al. Short- and mid-term outcomes of sleeve gastrectomy for morbid obesity: the experience of the Spanish National Registry. Obes Surg. 2009;19(9):1203–10.CrossRef
21.
Zurück zum Zitat 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.CrossRef 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.CrossRef
22.
Zurück zum Zitat Knapps J, Ghanem M, Clements J, et al. A systematic review of staple-line reinforcement min laparoscopic sleeve gastrectomy. JSLS. 2013;17(3):390–9.CrossRef Knapps J, Ghanem M, Clements J, et al. A systematic review of staple-line reinforcement min laparoscopic sleeve gastrectomy. JSLS. 2013;17(3):390–9.CrossRef
23.
Zurück zum Zitat Wang Z, Dai X, Xie H, et al. The efficacy of staple line reinforcement during laparoscopic sleeve gastrectomy: a meta-analysis of randomized controlled trials. Int J Surg. 2016;25:145–52.CrossRef Wang Z, Dai X, Xie H, et al. The efficacy of staple line reinforcement during laparoscopic sleeve gastrectomy: a meta-analysis of randomized controlled trials. Int J Surg. 2016;25:145–52.CrossRef
24.
Zurück zum Zitat Dapri G, Cadiere GB, Himpens J. Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing three different techniques. Obes Surg. 2010;20(4):462–7.CrossRef Dapri G, Cadiere GB, Himpens J. Reinforcing the staple line during laparoscopic sleeve gastrectomy: prospective randomized clinical study comparing three different techniques. Obes Surg. 2010;20(4):462–7.CrossRef
25.
Zurück zum Zitat Choi YY, Bae J, Hur KY, et al. Reinforcing the staple line during laparoscopic sleeve gastrectomy: does it have advantages? A meta-analysis. Obes Surg. 2012;22:1206–13.CrossRef Choi YY, Bae J, Hur KY, et al. Reinforcing the staple line during laparoscopic sleeve gastrectomy: does it have advantages? A meta-analysis. Obes Surg. 2012;22:1206–13.CrossRef
26.
Zurück zum Zitat Gagner M, Buchwald JN. Comparison of laparoscopic sleeve gastrectomy leak rates in four staple-line reinforcement options: a systematic review. Surg Obes Relat Dis. 2014;10(4):713–23.CrossRef Gagner M, Buchwald JN. Comparison of laparoscopic sleeve gastrectomy leak rates in four staple-line reinforcement options: a systematic review. Surg Obes Relat Dis. 2014;10(4):713–23.CrossRef
28.
Zurück zum Zitat Sethi M, Zagzag J, Patel K, et al. Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy. Surg Endosc. 2016;30(3):883–91.CrossRef Sethi M, Zagzag J, Patel K, et al. Intraoperative leak testing has no correlation with leak after laparoscopic sleeve gastrectomy. Surg Endosc. 2016;30(3):883–91.CrossRef
29.
Zurück zum Zitat Bingham J, Lallemand M, Barron M, et al. Routine intraoperative leak testing for sleeve gastrectomy: is the leak test full of hot air? Am J Surg. 2016;211(5):943–7.CrossRef Bingham J, Lallemand M, Barron M, et al. Routine intraoperative leak testing for sleeve gastrectomy: is the leak test full of hot air? Am J Surg. 2016;211(5):943–7.CrossRef
30.
Zurück zum Zitat Bingham J, Kaufman J, Hata K, et al. A multicenter study of routine versus selective intraoperative leak testing for sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(9):1469–75.CrossRef Bingham J, Kaufman J, Hata K, et al. A multicenter study of routine versus selective intraoperative leak testing for sleeve gastrectomy. Surg Obes Relat Dis. 2017;13(9):1469–75.CrossRef
31.
Zurück zum Zitat Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: review of its prevention and management. World J Gastroenterol. 2014;20(38):13904–10.CrossRef Abou Rached A, Basile M, El Masri H. Gastric leaks post sleeve gastrectomy: review of its prevention and management. World J Gastroenterol. 2014;20(38):13904–10.CrossRef
32.
Zurück zum Zitat Gomberawalla A, Lutfi R. Benefits of intraoperative endoscopy: case report and review of 300 sleeves gastrectomies. Ann Surg Innov Res. 2015;9:13.CrossRef Gomberawalla A, Lutfi R. Benefits of intraoperative endoscopy: case report and review of 300 sleeves gastrectomies. Ann Surg Innov Res. 2015;9:13.CrossRef
33.
Zurück zum Zitat Wahby M, Salama AF, Elezaby AF, et al. Is routine postoperative gastrografin study needed after laparoscopic sleeve gastrectomy? Experience of 712 cases. Obes Surg. 2013;23(11):1711–7.CrossRef Wahby M, Salama AF, Elezaby AF, et al. Is routine postoperative gastrografin study needed after laparoscopic sleeve gastrectomy? Experience of 712 cases. Obes Surg. 2013;23(11):1711–7.CrossRef
34.
Zurück zum Zitat Albanopoulos K, Alevizos L, Linardoutsos D, et al. Routine abdominal drains after laparoscopic sleeve gastrectomy: a retrospective review of 353 patients. Obes Surg. 2011;21(6):687–91.CrossRef Albanopoulos K, Alevizos L, Linardoutsos D, et al. Routine abdominal drains after laparoscopic sleeve gastrectomy: a retrospective review of 353 patients. Obes Surg. 2011;21(6):687–91.CrossRef
Metadaten
Titel
Perioperative Practices Concerning Sleeve Gastrectomy – a Survey of 863 Surgeons with a Cumulative Experience of 520,230 Procedures
verfasst von
Md Tanveer Adil
Ali Aminian
Aparna Govil Bhasker
Reynu Rajan
Ricard Corcelles
Carlos Zerrweck
Yitka Graham
Kamal Mahawar
Publikationsdatum
01.11.2019
Verlag
Springer US
Erschienen in
Obesity Surgery / Ausgabe 2/2020
Print ISSN: 0960-8923
Elektronische ISSN: 1708-0428
DOI
https://doi.org/10.1007/s11695-019-04195-7

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