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Article 2 CITATION THE FIRST INTERNATIONAL CONSENSUS SUMMIT FOR SLEEVE GASTRECTOMY, NEW YORK CITY, OCTOBER 25–27, 2007 proximal to the pylorus. Deitel M, Crosby RD, Gagner M. The First International Summit for Sleeve Gastrectomy (SG), New York City, October 25–27, 2007. Obes Surg. 2008;18:487–496. PURPOSE OF THE STUDY The purpose of this article is to present the experiences of bariatric surgeons around the world who have performed laparoscopic sleeve gastrectomy (LSG) procedures. METHODS The first day of the meeting consisted of live surgery by expert surgeons performing LSG. The second day consisted of presentations by world experts. On the third day, the International Summit Consensus of experts met to determine the efficacy and technique of laparoscopic LSG as a primary procedure for bariatric surgery. RESULTS Postoperative LSG findings based on presentations were as follows: • A decrease in the ghrelin hormone due to the resection of the fundus—Patients experienced decreased appetites; after 3 years of surgery, patients regained their appetites but their estimated weight loss still increased. Findings based on questionnaire • Mean number of LSG patients per surgeon was 7.8±113.0 (median 27, range 2–850). • 93.8% of surgeons intended LSG to be their sole procedure; 50.9% required a second-stage procedure due to inadequate weight loss. • 79.5% reported no conversions from laparoscopic to open LSG. • Size of bougie used for LSG was 37.3±6.6. • 94.2% of surgeons first mobilize the greater curvature of the stomach before constructing the sleeve; 5.8% enter lesser sac and construct the sleeve before mobilizing the greater curvature. • Estimated fundus removed was 95.2±8.3%. • Resection commences 5.6±1.5cm • A significant increase in rate of gastric emptying into the duodenum after LSG • A reversal or improvement of type 2 diabetes, hypertension, and obstructive sleep apnea • Similar results as Roux-en-Y gastric bypass (RYGB) and better weight loss than after gastric banding • Patients with BMI >70kg/m2 required a second-stage procedure due to regain of weight 3 years after LSG. • Estimated percent of antrum removed was 40.1±28.2%. • 65.1% of surgeons leave a drain; 33.8% do not. • 97.5% of surgeons believe a silastic ring should not be placed around the sleeve. • For persisting fistulas, 47.6% of surgeons preferred fibrin glue; 59.1% preferred a stent. • Postoperative supplements were ordered by 64.1% of the surgeons and proton pump inhibitors by 83.1%. Complications Complications included high leaks (esophagogastric junction) (mean 1.6±SD 2.8), lower leaks (0.8±2.5), suture-line hemorrhage (1.6±2.6), splenic injury (0.1±0.7), liver injury (0.1±0.8), postop gastroesophageal reflux (4.7±8.9), and "other" (1.0±2.3). CONCLUSION According to the results discussed by surgeons, LSG decreases the production of ghrelin hormone, effectively decreases appetite postoperatively, and results in good excess weight loss (EWL). It also improves or completely resolves comorbidities such as type 2 diabetes and hypertension. 6S Bariatric Times • June 2012 • Supplement