Survey of Bariatric Surgeon Calibration Tube Use in Sleeve Gastrectomy.

Purpose: The study objective was to identify variations in calibration tube use during sleeve gastrectomy and understand elements of ideal calibration tube performance.

Materials and methods: A survey was distributed via email and social media to bariatric surgeons, who were asked to rate the performance of their current calibration tube and an ideal calibration tube for five technical milestones involving visualization, positioning, suction capability, and sleeve sizing. Data was analyzed using descriptive and bivariate analyses including chi-square, Mann-Whitney, and Kruskal-Wallis tests.

Results: After eliminating incorrect screening question responses, 552 of 585 responses were analyzed. Demographics included 82% practicing in the USA, 64% in community practice, performing an average of 114 (SD = 94.5) sleeves annually. Calibration tubes used were most commonly reusable (54.2%) versus disposable (27.4%), endoscope (5.3%), or other (13.2%). Ninety-six percent of calibration tube sizes were 32 to 44 French. The reusable calibration tube had the lowest mean scores in all five technical areas, while the endoscope performed the best. When comparing surgeon current to ideal calibration tube performance, the endoscope performed closest to an ideal device, with significant p-values for technical milestones (i-iv). Despite the endoscope having the highest ratings for technical performance, surgeons rated higher satisfaction using disposable calibration tubes.

Conclusion: Significant variation exists among the size and type of calibration tubes used for sleeve gastrectomy. Calibration tubes incorporating the visualization of an endoscope with the workflow of a disposable device could bridge technical performance and satisfaction goals for surgeons.