Technical Variations and Considerations around OAGB in IFSO-APC and IFSO-MENAC Chapters, an Expert Survey

Mohammad Kermansaravi; Shahab Shahabi Shahmiri; Lilian Kow; Khaled Gawdat; Syed Imran Abbas; Ahmad Aly; Ahmad Bashir; Mohit Bhandari; Ashraf Haddad; Mohamad Hayssam ElFawal; Atif Inam; Kazunori Kasama; Sang Hyun Kim; Kuldeepak Singh Kular; Muffazal Lakdawala; Laurent Abram Layani; Wei-Jei Lee; Abdolreza Pazouki; Arun Prasad; Bassem Safadi; Cunchuan Wang; Wah Yang; Reza Adib; Amir Hossein Davarpanah Jazi; Asim Shabbir; IFSO-APC/MENAC collaborators

doi:10.1007/s11695-024-07239-9

Technical Variations and Considerations around OAGB in IFSO-APC and IFSO-MENAC Chapters, an Expert Survey

Obes Surg. 2024 Apr 25. doi: 10.1007/s11695-024-07239-9. Online ahead of print.

Authors

Mohammad Kermansaravi¹, Shahab Shahabi Shahmiri², Lilian Kow³, Khaled Gawdat⁴, Syed Imran Abbas⁵, Ahmad Aly^{6

7}, Ahmad Bashir⁸, Mohit Bhandari⁹, Ashraf Haddad⁸, Mohamad Hayssam ElFawal¹⁰, Atif Inam¹¹, Kazunori Kasama¹², Sang Hyun Kim¹³, Kuldeepak Singh Kular¹⁴, Muffazal Lakdawala¹⁵, Laurent Abram Layani¹⁶, Wei-Jei Lee¹⁷, Abdolreza Pazouki², Arun Prasad¹⁸, Bassem Safadi¹⁹, Cunchuan Wang²⁰, Wah Yang²⁰, Reza Adib²¹, Amir Hossein Davarpanah Jazi²², Asim Shabbir²³; IFSO-APC/MENAC collaborators

Affiliations

¹ Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. mkermansaravi@yahoo.com.
² Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
³ Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia.
⁴ Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt.
⁵ Iranian Hospital, Al Wasl Road, Dubai, UAE.
⁶ Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia.
⁷ University of Melbourne, Melbourne, Australia.
⁸ Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC), Jordan Hospital, Amman, Jordan.
⁹ Mohak Bariatrics and Robotics Center, Indore, India.
¹⁰ Makassed General Hospital, Beirut, Lebanon.
¹¹ Metabolic, Thoracic & General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan.
¹² Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan.
¹³ Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea.
¹⁴ MGB-OAGB Club, Kular Research Institute, Bija, India.
¹⁵ Sir H N Reliance Foundation Hospital, Mumbai, India.
¹⁶ Al Sharq Hospital, Fujairah, UAE.
¹⁷ Medical Weight Loss Center, China Medical University Hsinchu Hospital, Zhubei, Taiwan.
¹⁸ Apollo Hospital, New Delhi, India.
¹⁹ Aman Hospital, Doha, Qatar.
²⁰ Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China.
²¹ The Wesley Hospital, Auchenflower, Queensland, Australia.
²² Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran. davarpanahjazi@gmail.com.
²³ National University of Singapore, Singapore, Singapore.

PMID: 38662251
DOI: 10.1007/s11695-024-07239-9

Abstract

Objective: This study aimed to evaluate the technical variations of one-anastomosis gastric bypass (OAGB) among IFSO-APC and MENAC experts.

Background: The multitude of technical variations and patient selection challenges among metabolic and bariatric surgeons worldwide necessitates a heightened awareness of these issues. Understanding different perspectives and viewpoints can empower surgeons performing OAGB to adapt their techniques, leading to improved outcomes and reduced complications.

Methods: The scientific team of IFSO-APC, consisting of skilled bariatric and metabolic surgeons specializing in OAGB, conducted a confidential online survey. The survey aimed to assess technical variations and considerations related to OAGB within the IFSO-APC and IFSO-MENAC chapters. A total of 85 OAGB experts participated in the survey, providing their responses through a 35-question online format. The survey took place from January 1, 2024, to February 15, 2024.

Results: Most experts do not perform OAGB for children and adolescents younger than 18 years. Most experts create the gastric pouch over a 36-40-F bougie and prefer to create a gastrojejunostomy, at the posterior wall of the gastric pouch. An anti-reflux suture during OAGB is performed in all patients by 51.8% of experts. Most experts set a common limb length of > 4 m in revisional and conversional OAGBs to prevent nutritional complications.

Conclusion: The ongoing debate among metabolic and bariatric surgeons regarding the technical variations and patient selection in OAGB remains a significant point of discussion. This survey demonstrated the variations in technical aspects and patient selection for OAGB among MBS surgeons in the IFSO-APC and IFSO-MENAC chapters. Standardizing the OAGB technique is crucial to ensure optimal safety and efficacy in this procedure.

Keywords: Mini gastric bypass; One-anastomosis gastric bypass; Survey; Technical variation.