The Second International Consensus Summit for Sleeve Gastrectomy, March 19-21, 2009

Area of Science:

• Bariatric Surgery
• Minimally Invasive Procedures
• Metabolic and Endocrine Disorders

Background:

• Sleeve gastrectomy (SG) is an increasingly utilized bariatric procedure known for its simplicity and effectiveness in resolving comorbidities and promoting weight loss.
• The Second International Consensus Summit for SG (ICSSG) convened to evaluate current techniques and outcomes, addressing the growing indications and variations in SG procedures.

Framework:

• The study is based on 106 questionnaires from attendees of the 2009 ICSSG, representing 14,776 sleeve gastrectomies.
• Data analysis focused on surgical techniques, peri-operative outcomes, and long-term weight loss results.

Implementation:

• SG was performed as a primary operation in 86.3% of cases, with a low conversion rate from laparoscopic to open procedures (81.9%).
• Standardized techniques included a mean bougie size of 35.6F, dissection initiated 5 cm proximal to the pylorus, and 95.8% fundus removal.
• Staple-line reinforcement was employed in 65.1% of cases, with over-sewing being the most common method.

Implications:

• Mean excess weight loss at 1 year was 60.7%, with sustained results up to 4 years.
• Peri-operative complication rates were low: high leaks (1.5%), hemorrhage (1.1%), splenic injury (0.1%), and stenosis (0.9%). Post-operative reflux occurred in 6.5%.
• The consensus concluded that SG is a highly promising primary operation for morbid obesity, comparable to adjustable gastric banding and Roux-en-Y gastric bypass.