A Delphi Consensus on Surgical Technique of Roux-en-Y Gastric Bypass: An Obesity and Metabolic Surgery Society of India Initiative
Vivek Bindal, Dhananjay Pandey, Randeep Wadhawan, Aparna Govil Bhasker, Ramen Gyanendra Goel, K. S. Kular, Sumeet Shah, Praveen Raj, Manish Khaitan, Mahendra Narwaria, Pradeep Chowbey, Shrihari Dhorepatil, Rajesh Khullar, Lashmi Kona Kumari, Atul N.C. Peters, Deep Goel, Manish Baijal, Shashank Shah, Sandeep Aggarwal, Surendra Ugale, Rajesh Bhojwani, Sanjay Patolia, Nandakishore Dukkipati, Shailesh Gupta, Shahiq AhmedAbstract
Introduction:
Roux-en-Y gastric bypass (RYGB) is considered the gold standard bariatric surgical procedure. However, its complexity has led to various technical adaptations being practiced globally, including in India. Recognizing the need for uniformity in such a crucial procedure, the Obesity Surgery Society of India (OSSI) took the initiative of doing a Delphi consensus on the technique of RYGB.
Methods:
A panel of 17 experts, chosen from OSSI members, was formed based on their extensive experience with RYGB, years of practice, the proportion of RYGB in their practice, and their academic contributions and recommendations from the executive committee. A questionnaire comprising 40 statements regarding the key steps of the procedure was shared with the selected experts through email. Consensus was deemed to be reached when the statements received scores exceeding 70%.
Results:
After three rounds of surveys, consensus was reached on 34 statements. Following the first round, statements without consensus underwent reformulation and were redistributed along with pertinent literature. Despite these efforts, six statements remained unresolved by the end of the third round, indicating areas where expert consensus could not be achieved.
Conclusions:
This Delphi consensus gives a snapshot in the practices of experts doing RYGB in India. It details the various intricacies and technical aspects of the procedure.