A peer-reviewed, evidence-based journal that promotes clinical development and metabolic insights in total bariatric patient care for the healthcare professional
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4th INTERNATIONAL CONSENSUS SUMMIT FOR SLEEVE GASTRECTOMY I: The Utilization of Sleeve Gastrectomy percent of gastric bypass operations were performed using the laparoscopic approach; however, by 2004–2005, the majority of bariatric operations had shifted to the laparoscopic approach, with laparoscopic gastric bypass being the most commonly performed bariatric operation.2,12 In 2001, the LAGB was approved by the FDA and by 2008, it accounted for 24 percent of all bariatric operations. Data prior to 2010, from the ASMBS Bariatric Outcomes Longitudinal Database (BOLD [2005–2009]), the American College of Surgeons Bariatric Surgery Center Network (ACS BSCN [2007–2010]), and the Michigan Bariatric Surgery Collaborative (2006–2010) showed that LAGB accounted for 39.6, 42.7, and 31.5 percent, respectively, of all bariatric operations reported in their series.7,13,14 Increase in utilization of LSG has superseded that of LAGB. The reasons for this finding are multifactorial and may include recognition of sleeve gastrectomy as a primary bariatric operation by the ASMBS;9 long-term weight loss with sleeve gastrectomy being comparable to that of gastric bypass;15 recent third-party payors' coverage for the sleeve gastrectomy procedure and inferior weight loss and high rate of band explantation associated with gastric banding at long-term follow up compared to gastric bypass and sleeve gastrectomy.6,16 There was also a continual decline in the use of open gastric bypass. This is not surprising as numerous reports have shown improved morbidity and mortality and equivalent long-term weight loss with laparoscopic gastric bypass compared to open gastric bypass.17,18 Perioperative morbidity and mortality for sleeve gastrectomy is positioned somewhere between laparoscopic gastric banding and laparoscopic gastric bypass. Data from the American College of Surgeons FIGURE 1. Quarterly distribution of bariatric operations performed at U.S. academic medical centers, October 1, 2008 to September 30, 2012. LAGB= laparoscopic adjustable gastric banding; LGB= laparoscopic gastric bypass; OGB= open gastric bypass; LSG= laparoscopic sleeve gastrectomy. Figure reprinted with permission from Nguyen NT, Nguyen B, Gebhart A, Hohmann S. Changes in the makeup of bariatric surgery: a national increase in the use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252–257. FIGURE 2. Quarterly distribution of U.S. academic medical centers performing bariatric operations, October 1, 2008 to September 30, 2012. LAGB= laparoscopic adjustable gastric banding; LGB= laparoscopic gastric bypass; OGB= open gastric bypass; LSG= laparoscopic sleeve gastrectomy. Figure reprinted with permission from Nguyen NT, Nguyen B, Gebhart A, Hohmann S. Changes in the makeup of bariatric surgery: a national increase in the use of laparoscopic sleeve gastrectomy. J Am Coll Surg. 2013;216(2):252–257. May 2013 • Supplement A • Bariatric Times A5