Background

Sleeve gastrectomy (SG) is the most popular bariatric operation, but surgical technique varies. Objective: To identify variations in calibration tube (CT) used during SG.

Methods

A survey was distributed via email and social media to bariatric surgeons. Data was received and analyzed.

Results

After eliminating incorrect screening question responses, 535 of 565 responses were analyzed. Demographics included 82% practicing in the United States, the majority in academic practice. Years in practice were 18% with 0-5 years, 20% with 6-10 years, 45% with 11-20 years, and 17% with greater than 20 years. Number of sleeves performed annually ranged between 25 to 300. Laparoscopic versus robotic sleeve gastrectomy were performed by 71% vs 6% of respondents. CTs used were reusable bougie (53.5%), disposable CT (37.4%), endoscope (5.4%), and 'other' (3.2%); less than 1% used no CT. Seventeen different types of disposable tubes were reported. The most common CT sizes were 36 French (Fr) (38%) and 40 Fr (36%), with sizes ranging from 18 to 54 Fr. The highest valued CT qualities included: efficient positioning, creating consistent sleeve size, and visualizing CT on introduction to stomach. Current spacing devices did not solve these issues. Fifty percent of respondents actively pursued alternate calibration devices.

Conclusions

Approximately half of bariatric surgeons perform SG with a reusable spacing device sized 36 or 40 Fr, the second largest group uses disposable CTs in a variety of sizes. Further standardizing SG technique may help understand how final sleeve geometry affects GERD and weight loss surgical outcomes.