Table 2: Delphi Consensus on Laparoscopic Roux-en-Y Gastric Bypass First Delphi round N Mean 95% CI Second Delphi Round N Mean 95% CI Opera2ve set up and star2ng of laparoscopy Checking of instruments 38 3.63 [3.24 - 4.02] 32 3.5 [3.11 - 3.89] Advised Posiqoning OR team 38 3.95 [3.65 - 4.24] 32 3.63 [3.24 - 4.01] Advised Posiqoning monitors 38 4.18 [3.9 - 4.47] 32 3.88 [3.59 - 4.16] Key step Posiqoning paqent 38 4.42 [4.17 - 4.67] Key step Time-out procedure 38 4.39 [4.11 - 4.68] Key step Checking of anqbioqc prophylaxis 38 4.16 [3.89 - 4.43] 32 3.84 [3.55 - 4.13] Key step Disinfecqon. sterile exposure 38 4.29 [4.04 - 4.54] Key step Checking introducqon gastric bougie 38 3.13 [2.66 - 3.6] 32 3.59 [3.13 - 4.06] Advised Introducqon Veress Needle 38 3.18 [2.66 - 3.71] 32 3.09 [2.66 - 3.53] Introducqon opqcal trocar 37 4.32 [4.04 - 4.61] Key step Insufflate to 15mmHg abdominal pressure 38 3.03 [2.7 - 3.35] 32 3.13 [2.81 - 3.44] Set gas flow to 40L/min 38 2.82 [2.46 - 3.17] 32 3.16 [2.82 - 3.49] Laparoscopic assessment of abdominal cavity 38 2.89 [2.51 - 3.28] 32 2.84 [2.39 - 3.29] Introducqon of addiqonal trocars under laparoscopic sight 38 4.08 [3.8 - 4.36] 32 3.94 [3.65 - 4.23] Key step Introducqon of liver retractor 38 4.05 [3.71 - 4.39] 32 4.19 [3.84 - 4.54] Key step Exposure of operaqve field 38 4.55 [4.3 - 4.8] Key step Checking presence of hiatus hernia 38 3.21 [2.86 - 3.56] 32 3.47 [3.11 - 3.82] Reducqon of hiatus hernia 38 3.16 [2.76 - 3.55] 32 3.38 [2.96 - 3.79] Correcqon of hiatus hernia 38 2.71 [2.34 - 3.08] 31 2.68 [2.28 - 3.07] Crea2on of the gastric pouch Idenqficaqon of second gastric vessel 35 2.43 [1.99 - 2.86] Excluded Opening pars flacid and lesser sac 35 2.83 [2.22 - 3.44] 31 3.97 [3.49 - 4.45] Advised Vagal nerve preservaqon 35 3.34 [2.88 - 3.81] 31 3.42 [3.16 - 3.68] Checking gastric bougie posiqon 35 4.26 [3.87 - 4.64] 31 3.65 [3.12 - 4.17] Advised Stapling horizontally 35 4.34 [4.04 - 4.64] Key step Waiqng 15 seconds between closing and firing stapler 35 2.94 [2.56 - 3.32] 31 2.87 [2.45 - 3.29] Checking 15 second duraqon by scrub nurse 35 1.8 [1.42 - 2.18] Excluded Firing stapler in cephaled direcqon alongside bougie 35 3.6 [3.09 - 4.11] 31 3.32 [2.77 - 3.88] 66 4
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