Laparoscopic Magenstrasse and Mill Gastroplasty (M&M): Midterm Results

Obes Surg. 2019 Oct;29(10):3212-3219. doi: 10.1007/s11695-019-03965-7.

Abstract

Background: The Magenstrasse and Mill gastroplasty (M&M) is a gastric restrictive procedure without band or stomach resection. Short-term evaluation of the laparoscopic procedure showed low morbidity and satisfactory results on weight loss. Evidence of the validity of the technique in the longer term is scarce.

Methods: Data from patients who underwent M&M procedure from May 2012 to September 2015 were retrospectively reviewed. Preoperative clinical characteristics and data up to 4 years after operation were analyzed.

Results: A total of 132 patients were included in this study with a mean age of 46 ± 13.4 years. The mean body mass index (BMI) at the time of procedure was 43 ± 4.5 kg/m2. Mean percentage of excess weight loss (%EWL) was 67, 67, 58, and 57% at 1, 2, 3, and 4 years, respectively. The remission rate for diabetes was 36%. About half of the insulin-dependent patients could stop their insulin treatment. Hypertension was resolved in 33.8% of the patients after 4 years. Incidence of vitamin and mineral deficiency was low throughout the study period, less than or equal to 3% for vitamin B12 and 1% for ferritin. Incidence of gastroesophageal reflux did not exceed 15% during the study. Over 75% of the patients reported a good or very good quality of life following the surgery.

Conclusion: These results confirm the validity of M&M as a bariatric procedure. The low incidence of vitamin deficiencies and gastroesophageal reflux might be the important asset of M&M over other existing techniques.

Keywords: Gastroplasty; Laparoscopic; Magenstrasse and Mill; Obesity; Sleeve; Surgery.

Publication types

  • Evaluation Study

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Body Mass Index
  • Diabetes Mellitus / surgery
  • Dietary Supplements
  • Female
  • Follow-Up Studies
  • Gastroesophageal Reflux / etiology
  • Gastroplasty / adverse effects
  • Gastroplasty / methods*
  • Gastroplasty / rehabilitation
  • Humans
  • Hypertension / surgery
  • Laparoscopy / adverse effects
  • Laparoscopy / methods
  • Malabsorption Syndromes / etiology
  • Male
  • Medication Adherence / statistics & numerical data
  • Middle Aged
  • Obesity, Morbid / physiopathology
  • Obesity, Morbid / rehabilitation
  • Obesity, Morbid / surgery*
  • Postoperative Complications
  • Quality of Life
  • Retrospective Studies
  • Treatment Outcome
  • Vitamins / blood
  • Vitamins / therapeutic use
  • Weight Loss

Substances

  • Vitamins