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. 2017 Sep;27(9):2222-2228.
doi: 10.1007/s11695-017-2663-0.

Understanding Objections to One Anastomosis (Mini) Gastric Bypass: A Survey of 417 Surgeons Not Performing this Procedure

Kamal K Mahawar  1 , Cynthia-Michelle Borg  2 , Kuldeepak Singh Kular  3 , Michael J Courtney  4 , Karim Sillah  4 , William R J Carr  4 , Neil Jennings  4 , Brijesh Madhok  5 , Rishi Singhal  6 , Peter K Small  4
Affiliations

Understanding Objections to One Anastomosis (Mini) Gastric Bypass: A Survey of 417 Surgeons Not Performing this Procedure

Kamal K Mahawar et al. Obes Surg. 2017 Sep.

Abstract

Background: Despite published experience with thousands of patients, the uptake of One Anastomosis/Mini Gastric Bypass (OAGB/MGB) has been less than enthusiastic and many surgeons still harbour objections to this procedure. The purpose of this study was to understand these objections scientifically.

Methods: Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey on SurveyMonkey®. Surgeons already performing this procedure were excluded.

Results: Four hundred seventeen bariatric surgeons (from 42 countries) not currently performing OAGB/MGB took the survey. There were 211/414 (50.97%) and 188/414 (45.41%) respondents who expressed concerns that it will lead to an increased risk of gastric and oesophageal cancers respectively. A total of 62/416 (14.9%) and 201/413 (n = 48.6%) surgeons respectively felt that OAGB/MGB was associated with a higher early (30-day) and late complication rate compared to the RYGB. Moreover, 7.8% (n = 32/411) and 16.26% (n = 67/412) of the respondents were concerned that OAGB/MGB carried a higher early (30-day) and late mortality, respectively, in comparison with the RYGB. There were 79/410 (19.27%) and 88/413 (21.3%) respondents who were concerned that OAGB/MGB was not an effective procedure for weight loss and co-morbidity resolution, respectively. A total of 258/411 (62.77%) respondents reported that OAGB/MGB was not approved by their national society as a mainstream bariatric procedure; 51.0% of these surgeons would start performing this procedure if it was.

Conclusions: Surgeons not performing OAGB/MGB cite a number of concerns for not performing this operation. This survey is the first scientific attempt to understand these objections scientifically.

Keywords: Bile reflux; Gastric cancer; Malnutrition; Mini gastric bypass; Objections; Oesophageal cancer; Omega loop gastric bypass; One anastomosis gastric bypass; Single anastomosis gastric bypass.

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