The first modified Delphi consensus statement on sleeve gastrectomy

Mahawar K.K. Omar I. Singhal R. Aggarwal S. Allouch M.I. Alsabah S.K. Angrisani L. Badiuddin F.M. Balibrea J.M. Bashir A. Behrens E. Bhatia K. Biertho L. Biter L.U. Dargent J. De Luca M. DeMaria E. Elfawal M.H. Fried M. Gawdat K.A. Graham Y. Herrera M.F. Himpens J.M. Hussain F.A. Kasama K. Kerrigan D. Kow L. Kristinsson J. Kurian M. Liem R. Lutfi R.E. Menon V. Miller K. Noel P. Ospanov O. Ozmen M.M. Peterli R. Ponce J. Prager G. Prasad A. Raj P.P. Rodriguez N.R. Rosenthal R. Sakran N. Santos J.N. Shabbir A. Shikora S.A. Small P.K. Taylor C.J. Wang C. Weiner R.A. Wylezol M. Yang W. Aminian A.
December 2021 Springer

Surgical Endoscopy
2021 #35 Issue 12 7027 - 7033 pp.

Introduction: Sleeve gastrectomy (SG) is the commonest bariatric procedure worldwide. Yet there is significant variation in practice concerning its various aspects. This paper report results from the first modified Delphi consensus-building exercise on SG. Methods: We established a committee of 54 globally recognized opinion makers in this field. The committee agreed to vote on several statements concerning SG. An agreement or disagreement amongst ≥ 70.0% experts was construed as a consensus. Results: The committee achieved a consensus of agreement (n = 71) or disagreement (n = 7) for 78 out of 97 proposed statements after two rounds of voting. The committee agreed with 96.3% consensus that the characterization of SG as a purely restrictive procedure was inaccurate and there was 88.7% consensus that SG was not a suitable standalone, primary, surgical weight loss option for patients with Barrett’s esophagus (BE) without dysplasia. There was an overwhelming consensus of 92.5% that the sleeve should be fashioned over an orogastric tube of 36–40 Fr and a 90.7% consensus that surgeons should stay at least 1 cm away from the angle of His. Remarkably, the committee agreed with 81.1% consensus that SG patients should undergo a screening endoscopy every 5 years after surgery to screen for BE. Conclusion: A multinational team of experts achieved consensus on several aspects of SG. The findings of this exercise should help improve the outcomes of SG, the commonest bariatric procedure worldwide, and guide future research on this topic.

Bariatric surgery , Gastric sleeve , Obesity surgery , Sleeve gastrectomy

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Bariatric Unit, South Tyneside and Sunderland NHS Trust, Sunderland, United Kingdom
Faculty of Health Sciences and Wellbeing, University of Sunderland, Sunderland, United Kingdom
Birmingham Heartlands Hospital, University Hospital Birmingham NHS Foundation Trust, Birmingham, United Kingdom
All India Institute of Medical Sciences (AIIMS), New Delhi, India
Nini Hospital, Tripoli, Lebanon
Kuwait University, Kuwait
University of Naples, Naples, Italy
Valiant Clinic, Dubayy, United Arab Emirates
Hospital Clínic de Barcelona, Barcelona, Spain
GBMC at Jordan Hospital, Amman, Jordan
New Life Center, Guatemala, Guatemala
Austin Health, Melbourne, Australia
Quebec Heart and Lung Institute-Laval University, Quebec, Canada
Franciscus Gasthuis Rotterdam, Rotterdam, Netherlands
Polyclinique Lyon Nord, Rillieux-la-Pape, France
Castelfranco Montebelluna Hospitals, Montebelluna, Italy
East Carolina University, Greenville, United States
Makassed General Hospital, Beirut, Lebanon
OB Klinika-Center for Treatment of Obesity and Metabolic Disorders, Prague, Czech Republic
Ain Shams School of Medicine, Cairo, Egypt
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, Mexico, Mexico
CHIREC Delta Hospital, Brussels, Belgium
Oregon Health & Science University, Portland, United States
Yotsuya Medical Cube, Tokyo, Japan
Phoenix Health, London, United Kingdom
Flinders University, Adelaide, SA, Australia
Oslo University Hospital, Oslo, Norway
New York University School of Medicine, NY, United States
Dutch Obesity Clinic (NOK), The Hague, Netherlands
University of Illinois, Chicago, United States
University Hospitals Coventry & Warwickshire NHS Trust, Coventry, United Kingdom
Diakonissen & Wehrle Private Hospital, Salzburg, Austria
Bouchard Private Hospital, Elsan, Marseille, France
Mediclinic Parkview, Dubayy, United Arab Emirates
KF “University Medical Center”, Nur-Sultan, Kazakhstan
Istinye University, Istanbul, Türkiye
University Hospital Basel, Basel, Switzerland
CHI Memorial Hospital, Chattanooga, TN, United States
Medical University of Vienna, Vienna, Austria
Apollo Hospitals, New Delhi, India
Gem Hospital, Chennai, India
Centro Médico Puerta de Hierro Andares, Zapopan, Mexico
Cleveland Clinic, Weston, FL, United States
Emek Medical Center, Afula, Israel
Jorge Manuel Nunes dos Santos, Lisbon, Portugal
National University Hospital, Singapore, Singapore
Brigham and Women’s Hospital, Harvard Medical School, Boston, United States
Concord Repatriation General Hospital, Sydney, Australia
The First Affiliated Hospital of Jinan University, Guangzhou, China
Department for Metabolic Surgery, Sana Klinikum Offenbach, Offenbach, Germany
Medical University of Warsaw, Warsaw, Poland
Cleveland Clinic, Cleveland, United States

Bariatric Unit
Faculty of Health Sciences and Wellbeing
Birmingham Heartlands Hospital
All India Institute of Medical Sciences (AIIMS)
Nini Hospital
Kuwait University
University of Naples
Valiant Clinic
Hospital Clínic de Barcelona
GBMC at Jordan Hospital
New Life Center
Austin Health
Quebec Heart and Lung Institute-Laval University
Franciscus Gasthuis Rotterdam
Polyclinique Lyon Nord
Castelfranco Montebelluna Hospitals
East Carolina University
Makassed General Hospital
OB Klinika-Center for Treatment of Obesity and Metabolic Disorders
Ain Shams School of Medicine
Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán
CHIREC Delta Hospital
Oregon Health & Science University
Yotsuya Medical Cube
Phoenix Health
Flinders University
Oslo University Hospital
New York University School of Medicine
Dutch Obesity Clinic (NOK)
University of Illinois
University Hospitals Coventry & Warwickshire NHS Trust
Diakonissen & Wehrle Private Hospital
Bouchard Private Hospital
Mediclinic Parkview
KF “University Medical Center”
Istinye University
University Hospital Basel
CHI Memorial Hospital
Medical University of Vienna
Apollo Hospitals
Gem Hospital
Centro Médico Puerta de Hierro Andares
Cleveland Clinic
Emek Medical Center
Jorge Manuel Nunes dos Santos
National University Hospital
Brigham and Women’s Hospital
Concord Repatriation General Hospital
The First Affiliated Hospital of Jinan University
Department for Metabolic Surgery
Medical University of Warsaw
Cleveland Clinic

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