Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in Poland

Introduction: Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in Poland. While considered technically straightforward, significant variation exists in the operative technique, which may affect safety outcomes. Aim: This study aimed to analyze the technical aspects and...

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Main Authors: Przemysław Sroczyński, Piotr Major, Michał R. Janik
Format: Article
Language:English
Published: Medycyna Praktyczna 2025-05-01
Series:Videosurgery and Other Miniinvasive Techniques
Subjects:
Online Access:https://www.mp.pl/videosurgery/issue/article/17954/
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author Przemysław Sroczyński
Piotr Major
Michał R. Janik
author_facet Przemysław Sroczyński
Piotr Major
Michał R. Janik
author_sort Przemysław Sroczyński
collection DOAJ
description Introduction: Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in Poland. While considered technically straightforward, significant variation exists in the operative technique, which may affect safety outcomes. Aim: This study aimed to analyze the technical aspects and complication rates of SG across Polish bariatric centers in 2023. Materials and methods: This is a secondary analysis of a nationwide survey conducted among bariatric centers affiliated with the Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons. As many as 54 centers participated, reporting detailed data on SG technique and outcomes. The centers were stratified by annual SG volume using a 50-procedure threshold, corresponding to the suggested learning curve. Results: A total of 7450 SG procedures were reported. Calibration bougies of 36 French were used by 70% of the centers. Staple line reinforcement was routinely performed in 72.5% of the centers, with oversewing and clipping as the most common methods. Leak tests were performed by 84.3% of the centers, while 66.7% omitted routine drain placement. Postoperative complication rates included bleeding (0.98%), leak (0.33%), reoperation (1.04%), and mortality (0.16%). Although not significant, complication rates were consistently higher in the centers performing fewer than 50 SGs annually. Conclusions: SG in Poland is characterized by favorable safety outcomes but notable procedural variability. While most centers follow recommended practices, a lack of standardization persists in key technical areas. Surgical volume may influence complication rates. National guidelines and structured training programs may help harmonize practice and improve outcomes.
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spelling doaj-art-5ddc6b770d4e41de9788b42173389c632025-08-20T03:30:44ZengMedycyna PraktycznaVideosurgery and Other Miniinvasive Techniques1895-45882299-00542025-05-0120220921410.20452/wiitm.2025.17954Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in PolandPrzemysław Sroczyński0Piotr Major1Michał R. Janik2General Surgery Department, Military Institute of Aviation Medicine, Warszawa, PolandSecond Department of General Surgery, Jagiellonian University Medical College, Kraków, PolandGeneral Surgery Department, Military Institute of Aviation Medicine, Warszawa, PolandIntroduction: Sleeve gastrectomy (SG) is the most frequently performed bariatric procedure in Poland. While considered technically straightforward, significant variation exists in the operative technique, which may affect safety outcomes. Aim: This study aimed to analyze the technical aspects and complication rates of SG across Polish bariatric centers in 2023. Materials and methods: This is a secondary analysis of a nationwide survey conducted among bariatric centers affiliated with the Metabolic and Bariatric Surgery Chapter of the Association of Polish Surgeons. As many as 54 centers participated, reporting detailed data on SG technique and outcomes. The centers were stratified by annual SG volume using a 50-procedure threshold, corresponding to the suggested learning curve. Results: A total of 7450 SG procedures were reported. Calibration bougies of 36 French were used by 70% of the centers. Staple line reinforcement was routinely performed in 72.5% of the centers, with oversewing and clipping as the most common methods. Leak tests were performed by 84.3% of the centers, while 66.7% omitted routine drain placement. Postoperative complication rates included bleeding (0.98%), leak (0.33%), reoperation (1.04%), and mortality (0.16%). Although not significant, complication rates were consistently higher in the centers performing fewer than 50 SGs annually. Conclusions: SG in Poland is characterized by favorable safety outcomes but notable procedural variability. While most centers follow recommended practices, a lack of standardization persists in key technical areas. Surgical volume may influence complication rates. National guidelines and structured training programs may help harmonize practice and improve outcomes.https://www.mp.pl/videosurgery/issue/article/17954/complicationsoperative techniquesleeve gastrectomystandardizationsurgical volume
spellingShingle Przemysław Sroczyński
Piotr Major
Michał R. Janik
Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in Poland
Videosurgery and Other Miniinvasive Techniques
complications
operative technique
sleeve gastrectomy
standardization
surgical volume
title Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in Poland
title_full Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in Poland
title_fullStr Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in Poland
title_full_unstemmed Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in Poland
title_short Technical variability and safety of sleeve gastrectomy: a nationwide survey of bariatric centers in Poland
title_sort technical variability and safety of sleeve gastrectomy a nationwide survey of bariatric centers in poland
topic complications
operative technique
sleeve gastrectomy
standardization
surgical volume
url https://www.mp.pl/videosurgery/issue/article/17954/
work_keys_str_mv AT przemysławsroczynski technicalvariabilityandsafetyofsleevegastrectomyanationwidesurveyofbariatriccentersinpoland
AT piotrmajor technicalvariabilityandsafetyofsleevegastrectomyanationwidesurveyofbariatriccentersinpoland
AT michałrjanik technicalvariabilityandsafetyofsleevegastrectomyanationwidesurveyofbariatriccentersinpoland