Similar to the collective experience among adult patients in the US, VSG has become the most common MBS procedure performed in the pediatric population.12,13 We will describe the technique utilized by pediatric surgeons at our institution.

Pre-operative preparation and intra-operative set up are similar to the standard laparoscopic approach including placement of sequential compression stockings, administration of subcutaneous heparin and preoperative antibiotics, and placement of an orogastric