• Users Online: 468
  • Print this page
  • Email this page
Year : 2023  |  Volume : 2  |  Issue : 2  |  Page : 79-84

A Delphi consensus on the surgical technique of laparoscopic sleeve gastrectomy: An obesity and metabolic surgery society of India initiative

1 Saifee Hospital, Mumbai, India
2 ILS Hospital, Kolkata, India
3 KD Hospital, Ahmedabad, India
4 Manipal Hospital, New Delhi, India
5 Kular Jospital, Bija, Punjab, India
6 Belle Vue Hospital, Kolkata, West Bengal, India
7 PSRI Hospital, Delhi, India
8 Max Hospital, Delhi, India
9 Department of General Surgery & Robotics, Bariatric & Robotic Surgeon, Max Superspeciality Hospital, Saket, New Delhi, India
10 Max Smart Superspecialty Hospital, Saket, Delhi, India
11 Max-BLK Super Specialty Hospital, New Delhi, India
12 Asian Bariatric Pvt. Ltd, Ahmedabad, Gujarat, India
13 Max Institute of Laparoscopic, Endoscopic and Bariatric Surgery, Hyderabad, India
14 LivLife Hospital, Hyderabad, India
15 Max Healthcare, New Delhi, India
16 Santokba Durlabhji Memorial Hospital, Jaipur, Rajasthan, India
17 Wockhardt Hospital, Mumbai, India
18 All India Institute of Medical Sciences, New Delhi, India
19 Breach Candy Hospital, Mumbai, India
20 Asian Bariatrics, Ahmedabad, India
21 Laparo-obeso Center, Pune, India
22 Shree Hospital, Pune, Maharashtra, India
23 Shanti Memorial Hospital, Cuttack, India
24 Gangaram Hospital, Delhi, India
25 Kirloskar Hospital, Hyderabad, India
26 Gem Hospital, Coimbatore, India

Correspondence Address:
Aparna Govil Bhasker
Saifee Hospital, Mumbai, Maharashtra
Login to access the Email id

Source of Support: None, Conflict of Interest: None

DOI: 10.4103/jbs.jbs_7_23

Rights and Permissions

Introduction: Laparoscopic sleeve gastrectomy (LSG) is the commonest bariatric operation being performed in India and worldwide. There are many technical variations that are being practiced. This Delphi consensus was an Obesity and Metabolic Surgery Society of India (OSSI) initiative to standardize the surgical technique of LSG. Methods: Twenty bariatric surgeons were selected as experts based on their years of experience in LSG, overall patient volumes, publications, and the recommendations of the executive committee of OSSI, to vote on 26 statements regarding the surgical steps of LSG. The minimum cutoff for consensus was taken as 70%. Results: The committee achieved a consensus on 19 out of 26 statements in the first round. One question was sent for reconsideration and 3 were resent after modification. Finally, consensus was reached on 22 statements. The consensus was reached regarding the use of preoperative upper gastrointestinal endoscopy. 85.7% agreed on an antral length of 3–5 cm. 85.7% were in favor of dissecting the left crus of the diaphragm completely and 100% agreed on Roux-en y gastric bypass to be the procedure of choice in the presence of medically refractory gastroesophageal reflux disease with hiatus hernia. Most experts agreed that a calibration tube must be used during LSG and the recommended size was between 36 and 40 Fr. Ninety-five percent agreed that care must be taken to avoid narrowing at the incisura and also to stay away from the angle of His. 71.4% did not recommend any kind of staple line reinforcement and 71.4% recommended a postoperative leak test. Conclusion: This Delphi consensus is a step toward improving the quality of surgical outcomes of LSG in India. This document has attempted to establish technical specifications of performing LSG. This will in turn help to maximize the reliability, standardization, and safety of the procedure until more robust studies are published.

Print this article     Email this article
 Next article
 Previous article
 Table of Contents

 Similar in PUBMED
   Search Pubmed for
   Search in Google Scholar for
 Related articles
 Citation Manager
 Access Statistics
 Reader Comments
 Email Alert *
 Add to My List *
 * Requires registration (Free)

 Article Access Statistics
    PDF Downloaded82    
    Comments [Add]    

Recommend this journal