title: International Sleeve Gastrectomy Expert Panel Consensus Statement: best practice guidelines based on experience of >12,000 cases.
abstract: BACKGROUND
  Laparoscopic sleeve gastrectomy (LSG) is an emerging surgical approach, but 1 that has seen a surge in popularity because of its perceived technical simplicity, feasibility, and good outcomes. An international expert panel was convened in Coral Gables, Florida on March 25 and 26, 2011, with the purpose of providing best practice guidelines through consensus regarding the performance of LSG. The panel comprised 24 centers and represented 11 countries, spanning all major regions of the world and all 6 populated continents, with a collective experience of >12,000 cases. It was thought prudent to hold an expert consensus meeting of some of the surgeons across the globe who have performed the largest volume of cases to discuss and provide consensus on the indications, contraindications, and procedural aspects of LSG. The panel undertook this consensus effort to help the surgical community improve the efficacy, lower the complication rates, and move toward adoption of standardized techniques and measures. The meeting took place at on-site meeting facilities, Biltmore Hotel, Coral Gables, Florida.
  
  
  METHODS
  Expert panelists were invited to participate according to their publications, knowledge and experience, and identification as surgeons who had performed >500 cases. The topics for consensus encompassed patient selection, contraindications, surgical technique, and the prevention and management of complications. The responses were calculated and defined as achieving consensus (≥70% agreement) or no consensus (<70% agreement).
  
  
  RESULTS
  Full consensus was obtained for the essential aspects of the indications and contraindications, surgical technique, management, and prevention of complications. Consensus was achieved for 69 key questions.
  
  
  CONCLUSIONS
  The present consensus report represents the best practice guidelines for the performance of LSG, with recommendations in the 3 aforementioned areas. This report and its findings support a first effort toward the standardization of techniques and adoption of working recommendations formulated according to expert experience.
authors.affiliation: Department of Surgery, Section of Minimally Invasive Surgery, Cleveland Clinic Florida, 2950 Cleveland Clinic Boulevard, Weston, FL 33331, USA. rosentr@ccf.org
authors.forename: Raul J
authors.initials: RJ
authors.lastname: Rosenthal
authors.forename: Alberto Aceves
authors.initials: AA
authors.lastname: Diaz
authors.forename: Dag
authors.initials: D
authors.lastname: Arvidsson
authors.forename: Randal S
authors.initials: RS
authors.lastname: Baker
authors.forename: Nicola
authors.initials: N
authors.lastname: Basso
authors.forename: Drake
authors.initials: D
authors.lastname: Bellanger
authors.forename: Camilo
authors.initials: C
authors.lastname: Boza
authors.forename: Haicam
authors.initials: H
authors.lastname: El Mourad
authors.forename: Michael
authors.initials: M
authors.lastname: France
authors.forename: Michel
authors.initials: M
authors.lastname: Gagner
authors.forename: Manoel
authors.initials: M
authors.lastname: Galvao-Neto
authors.forename: Kelvin D
authors.initials: KD
authors.lastname: Higa
authors.forename: Jacques
authors.initials: J
authors.lastname: Himpens
authors.forename: Colleen M
authors.initials: CM
authors.lastname: Hutchinson
authors.forename: Moises
authors.initials: M
authors.lastname: Jacobs
authors.forename: John O
authors.initials: JO
authors.lastname: Jorgensen
authors.forename: Gregg
authors.initials: G
authors.lastname: Jossart
authors.forename: Muffazal
authors.initials: M
authors.lastname: Lakdawala
authors.forename: Ninh T
authors.initials: NT
authors.lastname: Nguyen
authors.forename: David
authors.initials: D
authors.lastname: Nocca
authors.forename: Gerhard
authors.initials: G
authors.lastname: Prager
authors.forename: Alfons
authors.initials: A
authors.lastname: Pomp
authors.forename: Almino Cardoso
authors.initials: AC
authors.lastname: Ramos
authors.forename: Raul J
authors.initials: RJ
authors.lastname: Rosenthal
authors.forename: Shashank
authors.initials: S
authors.lastname: Shah
authors.forename: Michel
authors.initials: M
authors.lastname: Vix
authors.forename: Alan
authors.initials: A
authors.lastname: Wittgrove
authors.forename: Natan
authors.initials: N
authors.lastname: Zundel
mesh_terms: D000328:Adult; D019317:Evidence-Based Medicine; D005260:Female; D005743:Gastrectomy / Q000592:standards*; D006801:Humans; D010535:Laparoscopy / Q000592:standards*; D008297:Male; D008875:Middle Aged; D011183:Postoperative Complications / Q000517:prevention & control; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians' / Q000706:statistics & numerical data; D011795:Surveys and Questionnaires