Practices concerning Roux-en-Y Gastric Bypass - a global survey of 651 Bariatric and metabolic surgeons
There is significant variation in practices concerning Roux-en-Y gastric bypass (RYGB) amongst bariatric and metabolic surgeons and there is little data characterising this variation. The purpose of this study was to understand the global variations in the technical and perioperative practices concerning RYGB.
A questionnaire based survey on Survey Monkey® was freely distributed amongst personal contact networks and various online social media groups for bariatric and metabolic surgeons.
651 respondents from 65 countries completed the survey. Crohn’s disease and liver cirrhosis were considered by the majority of respondents to be absolute contraindications to RYGB. 68.5% of surgeons routinely performed upper GI endoscopy and 64.2% performed abdominal ultrasound preoperatively. 79.6% used an orogastric bougie to assist gastric pouch creation and 77.7% favoured a perigastric technique. 72.2% of respondents did not use staple line reinforcement routinely. Only 17.7% of surgeons measured the whole small bowel length and 86.5% used a constant length of Bilio-pancreatic (BP) limb. The most common routine BP limb length was between 76-100cm by 26.73% of respondents. Marginal ulcer prophylaxis was used by the majority of respondents and 95% recommended lifelong vitamin and mineral supplementation after surgery.
This survey characterises the global variation in practice concerning RYGB and identifies areas where future research and consensus building can contribute.