Technical controversies in laparoscopic sleeve gastrectomy

Laparoscopic sleeve gastrectomy is a recently developed technique for treating morbid obesity. Since it is a simple procedure, many bariatric surgeons have adopted it in recent years with good results. However, there is still no standard procedure across different surgical teams. We will discuss the more controversial aspects of the surgical technique: the size of the bougie, the beginning of the distal section, the section shape at the gastroesophageal junction, the necessity and manner of reinforcing the staple line, and the routine use of intraoperative leak testing.