Perioperative Practices Concerning One Anastomosis (Mini) Gastric Bypass: A Survey of 210 Surgeons

Obes Surg. 2018 Jan;28(1):204-211. doi: 10.1007/s11695-017-2831-2.

Abstract

Background: There is currently little evidence available on the perioperative practices concerning one anastomosis/mini gastric bypass (OAGB/MGB) and no published consensus amongst experts. Even the published papers are not clear on these aspects. The purpose of this study was to understand various perioperative practices concerning OAGB/MGB.

Methods: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey. Only surgeons performing this procedure were included.

Results: Two hundred and ten surgeons from 39 countries with a cumulative experience of 68,442 procedures took the survey. Surgeons described a large number of absolute (n = 55) and relative contraindications (n = 59) to this procedure in their practice. Approximately 71.0% (n = 148/208), 70.0% (n = 147/208) and 65.0% (n = 137/209), respectively, routinely perform a preoperative endoscopy, screening for Helicobacter pylori and ultrasound scan of the abdomen. A minority (35.0%, n = 74/208) of the surgeons used a constant bilio-pancreatic limb (BPL) length for all the patients with remaining preferring to tailor the limb length to the patient and approximately half (49.0%, n = 101/206) routinely approximate diaphragmatic crura in patients with hiatus hernia. Some 48.5% (n = 101/208) and 40.0% (n = 53/205) surgeons, respectively, do not recommend routine iron and calcium supplementation.

Conclusion: This survey is the first attempt to understand a range of perioperative practices with OAGB/MGB. The findings will help in identifying areas for future research and allow consensus building amongst experts with preparation of guidelines for future practice.

Keywords: Cancer; Mini gastric bypass; Objections; Omega loop gastric bypass; One anastomosis gastric bypass; Perioperative practices; Single anastomosis gastric bypass.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Choice Behavior
  • Female
  • Gastric Bypass / methods*
  • Gastric Bypass / statistics & numerical data
  • Geography
  • Humans
  • Male
  • Middle Aged
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Perioperative Care / methods*
  • Perioperative Care / statistics & numerical data
  • Practice Patterns, Physicians' / statistics & numerical data*
  • Surgeons / statistics & numerical data*
  • Surveys and Questionnaires
  • Young Adult