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Global Variations in Practices Concerning Roux-en-Y Gastric Bypass—an Online Survey of 651 Bariatric and Metabolic Surgeons with Cumulative Experience of 158,335 Procedures

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Abstract

Introduction

There is significant variation in practices concerning Roux-en-Y gastric bypass (RYGB) among bariatric surgeons, but there is currently a lack of robust data on the nature and extent of these variations. The purpose of this study was to understand global variations in practices concerning RYGB.

Methods

A questionnaire-based survey on Survey Monkey® was created, and the link was shared freely on various social media platforms. The link was also distributed through a personnel email network of authors.

Results

A total of 657 surgeons from 65 countries completed the survey. Crohn’s disease and liver cirrhosis were considered absolute contraindications for RYGB by 427 surgeons (64.98%) and 347 surgeons (53.30%), respectively. More than 68.5% of surgeons performed routine upper GI endoscopy while 64.17% performed routine ultrasound of abdomen preoperatively. The majority of surgeons (77.70%) used the perigastric technique for Gastric pouch creation. Approximately, 79.5% used orogastric bougie. More than 70% of the respondents did not use any staple line reinforcement routinely. Only 17.67% of surgeons measured the whole small bowel length, and the majority of surgeons (86.5%) used constant length of BP limb. Approximately, 89% used constant length of alimentary limb. Approximately, 95% of surgeons preferred antecolic bypass, and more than 86% routinely closed the Petersen defect. Marginal ulcer prophylaxis was used by the majority (91.17%). Almost 95% of surgeons recommended lifelong vitamin and mineral supplements.

Conclusion

This survey identifies global variations in practices concerning RYGB. It identifies several areas for future research and consensus building.

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Authors and Affiliations

  1. Sir Charles Gairdner Hospital, Nedlands, Western Australia

    Parveen Kumar & Ho-Cing Victor Yau

  2. Fiona Stanley Hospital, Murdoch, Western Australia

    Anand Trivedi

  3. Joondalup Health Campus, Joondalup, Western Australia

    David Yong

  4. Bariatric Unit, Sunderland Royal Hospital, Sunderland, UK

    Kamal Mahawar

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  1. Parveen Kumar
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Correspondence to Parveen Kumar.

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Kumar, P., Yau, HC.V., Trivedi, A. et al. Global Variations in Practices Concerning Roux-en-Y Gastric Bypass—an Online Survey of 651 Bariatric and Metabolic Surgeons with Cumulative Experience of 158,335 Procedures. OBES SURG 30, 4339–4351 (2020). https://doi.org/10.1007/s11695-020-04796-7

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