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Rosenthal RJ, International Sleeve Gastrectomy Expert P, Diaz AA, et al. International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases

Department of Surgery, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA.
Surgery for Obesity and Related Diseases (Impact Factor: 4.94). 01/2012; 8(1):8-19. DOI: 10.1016/j.soard.2011.10.019
Source: PubMed

ABSTRACT Laparoscopic sleeve gastrectomy (LSG) is an emerging surgical approach, but 1 that has seen a surge in popularity because of its perceived technical simplicity, feasibility, and good outcomes. An international expert panel was convened in Coral Gables, Florida on March 25 and 26, 2011, with the purpose of providing best practice guidelines through consensus regarding the performance of LSG. The panel comprised 24 centers and represented 11 countries, spanning all major regions of the world and all 6 populated continents, with a collective experience of >12,000 cases. It was thought prudent to hold an expert consensus meeting of some of the surgeons across the globe who have performed the largest volume of cases to discuss and provide consensus on the indications, contraindications, and procedural aspects of LSG. The panel undertook this consensus effort to help the surgical community improve the efficacy, lower the complication rates, and move toward adoption of standardized techniques and measures. The meeting took place at on-site meeting facilities, Biltmore Hotel, Coral Gables, Florida.
Expert panelists were invited to participate according to their publications, knowledge and experience, and identification as surgeons who had performed >500 cases. The topics for consensus encompassed patient selection, contraindications, surgical technique, and the prevention and management of complications. The responses were calculated and defined as achieving consensus (≥70% agreement) or no consensus (<70% agreement).
Full consensus was obtained for the essential aspects of the indications and contraindications, surgical technique, management, and prevention of complications. Consensus was achieved for 69 key questions.
The present consensus report represents the best practice guidelines for the performance of LSG, with recommendations in the 3 aforementioned areas. This report and its findings support a first effort toward the standardization of techniques and adoption of working recommendations formulated according to expert experience.

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    • "Laparoscopic sleeve gastrectomy (LSG) is a relatively new and increasingly popular surgical approach, due to its perceived simplicity of surgical technique and good midterm outcomes. However, due to the past lack of standardization associated with LSG, the results may differ between surgical teams [6] and consequently QOL outcomes may also differ. Some data suggest that LSG is just as effective as RYGB in improving QOL [7], but also less than desired QOL results have been reported [8]. "
    Surgery for Obesity and Related Diseases 06/2014; 11(1). DOI:10.1016/j.soard.2014.06.003 · 4.94 Impact Factor
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    • "Les deux gestes les plus souvent réalisés sont la pose d'un anneau gastrique (LAGB) et le by-pass gastrique (by-pass Roux-en-Y), mais la sleeve gastrectomie (SG) ou gastrectomie en gouttière est une technique de chirurgie bariatrique en usage croissant. La SG est de plus en plus prisée des chirurgiens bariatriques et des patients principalement en raison de sa relative simplicité et de son plus faible risque opératoire [5] [6]. Pour une appréciation exacte de la nouvelle morphologie gastrique, les radiologues doivent comprendre la technique chirurgicale, car les complications anatomiques ou spécifiques au geste peuvent parfois être rendu difficile en postopératoire. "
    09/2013; 94(9):835-846. DOI:10.1016/j.jradio.2012.10.010
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    • "The two procedures most frequently performed are laparoscopic C. Chivot et al. adjustable gastric band (LAGB) and laparoscopic gastric bypass (LGB), but laparoscopic sleeve gastrectomy is an increasingly used bariatric surgical procedure. Sleeve gastrectomy has gained popularity among bariatric surgeons and patients, mainly due to its relatively simple technique and its lower risk profile [5] [6]. "
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    ABSTRACT: Morbid obesity is a public health problem in the United States and Europe and its prevalence is on the increase. Despite certain progress the efficacy of medical treatment remains limited. Bariatric surgery has consequently become an effective alternative for patients with morbid obesity. The bariatric operations most frequently performed are laparoscopic adjustable gastric banding (LAGB) and Roux-en-Y gastric bypass (LGB), but laparoscopic sleeve gastrectomy (LSG) is increasingly popular with both bariatric surgeons and patients due to its simplicity, rapidity and decreased morbidity. The purpose of this pictorial essay is to familiarize radiologists with the normal postoperative anatomic features and the imaging findings of postoperative gastrointestinal complications of laparoscopic sleeve gastrectomy because little literature exists on this subject.
    05/2013; 225(9). DOI:10.1016/j.diii.2013.03.017
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