Background

Sleeve Gastrectomy (SG) is the most commonly performed Metabolic and Bariatric Surgery (MBS) procedure. Technical considerations related to the performance of SG are well-established and reported in the literature but not in relation to Robotic Assisted (RA) SG. We report the results of the First Modified Delphi Consensus addressing technical considerations of robotic assisted daVinci (dV)-SG

Methods

A Consensus Building Committee (CBC) was created and comprised 10 experts in the field of RA- Surgery and MBS based on strict selection criteria. The CBC developed 49 consensus statements which were then shared with 240 experts in RA-surgery. Our stopping criterion was stability in responses (15% or less). The consensus cutpoint was 70%,

Results

The overall response rate was 49%. In the first round of voting, there was consensus agreement on 25 statements ( 51%) and consensus disagreement on 14 (28%) and no consensus on the remaining statements (21%). In the second round of voting we reached agreement on two additional statements. Experts recommended the use of the number of pauses generated by the stapler to guide choice of staple height (91.2%) and to upsize the size of the staple height when using buttressing (92%). There was also consensus (81.4%) that the use of closed staple height of 1.00 mm (white ) is acceptable and that stapling of antrum using 1.5 mm (blue load) is also acceptable (73%).

Conclusions

Collective expert opinion structured through a modified delphi consensus statement present a practical guide for surgeons interested in performing dV-SG