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. 2017 May;27(5):1153-1167.
doi: 10.1007/s11695-016-2428-1.

Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients

Miguel A Carbajo  1 , Enrique Luque-de-León  2 , José M Jiménez  2 , Javier Ortiz-de-Solórzano  2 , Manuel Pérez-Miranda  2 , María J Castro-Alija  2
Affiliations

Laparoscopic One-Anastomosis Gastric Bypass: Technique, Results, and Long-Term Follow-Up in 1200 Patients

Miguel A Carbajo et al. Obes Surg. 2017 May.

Abstract

Background: Excellent results have been reported with mini-gastric bypass. We adopted and modified the one-anastomosis gastric bypass (OAGB) concept. Herein is our approach, results, and long-term follow-up (FU).

Methods: Initial 1200 patients submitted to laparoscopic OAGB between 2002 and 2008 were analyzed after a 6-12-year FU. Mean age was 43 years (12-74) and body mass index (BMI) 46 kg/m2 (33-86). There were 697 (58 %) without previous or simultaneous abdominal operations, 273 (23 %) with previous, 203 (17 %) with simultaneous, and 27 (2 %) performed as revisions.

Results: Mean operating time (min) was as follows: (a) primary procedure, 86 (45-180); (b) with other operations, 112 (95-230); and (c) revisions, 180 (130-240). Intraoperative complications led to 4 (0.3 %) conversions. Complications prompted operations in 16 (1.3 %) and were solved conservatively in 12 (1 %). Long-term complications occurred in 12 (1 %). There were 2 (0.16 %) deaths. Thirty-day and late readmission rates were 0.8 and 1 %. Cumulative FU was 87 and 70 % at 6 and 12 years. The highest mean percent excess weight loss was 88 % (at 2 years), then 77 and 70 %, 6 and 12 years postoperatively. Mean BMI (kg/m2) decreased from 46 to 26.6 and was 28.5 and 29.9 at those time frames. Remission or improvement of comorbidities was achieved in most patients. The quality of life index was satisfactory in all parameters from 6 months onwards.

Conclusions: Laparoscopic OAGB is safe and effective. It reduces difficulty, operating time, and early and late complications of Roux-en-Y gastric bypass. Long-term weight loss, resolution of comorbidities, and degree of satisfaction are similar to results obtained with more aggressive and complex techniques. It is currently a robust and powerful alternative in bariatric surgery.

Keywords: Bariatric surgery; Billroth II gastric bypass; Diabetes surgery; Laparoscopic gastric bypass; Long-term follow-up; MGB; Metabolic surgery; Mini-gastric bypass; Morbid obesity; OAGB; Omega loop gastric bypass; One anastomosis gastric bypass; Single-anastomosis gastric bypass; Single-loop gastric bypass; Weight loss.

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Conflict of interest statement

Conflict of Interest

The authors declare that they have no conflict of interest.

Statement of Consent

Informed consent was obtained from all individual participants included in the study.

Statement of Human and Animal Rights

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Figures

Fig. 1
Fig. 1
Sites for trocar placement in laparoscopic one-anastomosis gastric bypass which include one 10 mm (camera), two 12 mm (surgeon’s operating ports), and three 5 mm trocars for liver retraction and small bowel and stomach mobilization
Fig. 2
Fig. 2
Diagrammatic representation of the one-anastomosis gastric bypass with gastric pouch (∼15 cm) and latero-lateral anastomosis. The afferent loop is suspended 8–10 cm above the anastomosis. The biliopancreatic limb averages 250–350 cm
See this image and copyright information in PMC

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