Technical Considerations in One Anastomosis Gastric Bypass-the Israeli Society of Metabolic and Bariatric Surgery Experience.

Biliopancreatic limb length ISMBS One anastomosis gastric bypass Technique

Journal

Obesity surgery
ISSN: 1708-0428
Titre abrégé: Obes Surg
Pays: United States
ID NLM: 9106714

Informations de publication

Date de publication:
23 Apr 2024
Historique:
received: 20 02 2024
accepted: 10 04 2024
revised: 30 03 2024
medline: 23 4 2024
pubmed: 23 4 2024
entrez: 22 4 2024
Statut: aheadofprint

Résumé

One anastomosis gastric bypass (OAGB) is gaining popularity worldwide due to its safety and effectiveness. OAGB is the most commonly performed metabolic bariatric surgery (MBS) in Israel. Israel is the only country where OAGB is the most prevalent MBS. Our aim is to address OAGB technical aspects using a national survey completed by members of the Israeli Society of Metabolic and Bariatric Surgery (ISMBS). An online-survey composed of a 17-item-based questionnaire was sent to ISMBS members. All responses were collected and analyzed. A total of 47/64 (73.4%) ISMBS members participated in the survey. Most surgeons (74.5%) had > 10 years of MBS experience, and most (61.7%) performed > 100 MBS/year. The majority (78.7%) perform OAGB as their most common procedure. Most surgeons fashion a 10-15-cm pouch and use a 36-Fr bougie, (57.4% and 38.3%). Regarding bowel length measurement, 70% use visual estimation and 10.6% routinely measure total small bowel length (TSBL). The most common reasons for creating a longer biliopancreatic limb (BPL) were high body mass index (BMI) and revisional surgery (83.3% and 66%, respectively). In a primary procedure of a patient with a BMI = 40, most (76.6%) would create a 150-200-cm BPL. In patients with a BMI > 50 or revisional cases, most (70.2% and 68.0%) would create a 175-225-cm BPL. OAGB is the most prevalent MBS performed in Israel. This survey showed common preferences and variations among ISMBS members. Further studies are needed in order to standardize and build a consensus on OAGB technique.

Sections du résumé

BACKGROUND BACKGROUND
One anastomosis gastric bypass (OAGB) is gaining popularity worldwide due to its safety and effectiveness. OAGB is the most commonly performed metabolic bariatric surgery (MBS) in Israel. Israel is the only country where OAGB is the most prevalent MBS. Our aim is to address OAGB technical aspects using a national survey completed by members of the Israeli Society of Metabolic and Bariatric Surgery (ISMBS).
MATERIALS AND METHODS METHODS
An online-survey composed of a 17-item-based questionnaire was sent to ISMBS members. All responses were collected and analyzed.
RESULTS RESULTS
A total of 47/64 (73.4%) ISMBS members participated in the survey. Most surgeons (74.5%) had > 10 years of MBS experience, and most (61.7%) performed > 100 MBS/year. The majority (78.7%) perform OAGB as their most common procedure. Most surgeons fashion a 10-15-cm pouch and use a 36-Fr bougie, (57.4% and 38.3%). Regarding bowel length measurement, 70% use visual estimation and 10.6% routinely measure total small bowel length (TSBL). The most common reasons for creating a longer biliopancreatic limb (BPL) were high body mass index (BMI) and revisional surgery (83.3% and 66%, respectively). In a primary procedure of a patient with a BMI = 40, most (76.6%) would create a 150-200-cm BPL. In patients with a BMI > 50 or revisional cases, most (70.2% and 68.0%) would create a 175-225-cm BPL.
CONCLUSION CONCLUSIONS
OAGB is the most prevalent MBS performed in Israel. This survey showed common preferences and variations among ISMBS members. Further studies are needed in order to standardize and build a consensus on OAGB technique.

Identifiants

pubmed: 38649670
doi: 10.1007/s11695-024-07223-3
pii: 10.1007/s11695-024-07223-3
doi:

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Informations de copyright

© 2024. The Author(s).

Références

Brown et al. 7th IFSO global registry report, 2022.   https://www.ifso.com/pdf/ifso-7th-registry-report-2022.pdf .
Chevallier JM, Arman GA, Guenzi M, et al. One thousand single anastomosis (omega loop) gastric bypasses to treat morbid obesity in a 7-year period: outcomes show few complications and good efficacy. Obes Surg. 2015;25(6):951–8. https://doi.org/10.1007/s11695-014-1552-z .
doi: 10.1007/s11695-014-1552-z pubmed: 25585612
The national registry for bariatric surgery in Israel - 2021 report. 2022. Israel Ministry of Health website - https://www.gov.il/BlobFolder/reports/report-bariatric-2020/he/files_publications_units_ICDC_bariatric-2020-report.pdf .
Lauti M, Kularatna M, Hill AG, et al. Weight regain following sleeve gastrectomy-a systematic review. Obes Surg. 2016;26(6):1326–34. https://doi.org/10.1007/s11695-016-2152-x .
doi: 10.1007/s11695-016-2152-x pubmed: 27048439
Saarinen T, Pietiläinen KH, Loimaala A, et al. Bile reflux is a common finding in the gastric pouch after one anastomosis gastric bypass. Obes Surg. 2020;30(3):875–81. https://doi.org/10.1007/s11695-019-04353-x .
doi: 10.1007/s11695-019-04353-x pubmed: 31853864
Carandina S, Soprani A, Zulian V, et al. Long-term results of one anastomosis gastric bypass: a single center experience with a minimum follow-up of 10 years. Obes Surg. 2021;31(8):3468–75. https://doi.org/10.1007/s11695-021-05455-1 .
doi: 10.1007/s11695-021-05455-1 pubmed: 34097238
Almuhanna M, Soong TC, Lee WJ, et al. Twenty years’ experience of laparoscopic 1-anastomosis gastric bypass: surgical risk and long-term results. Surg Obes Relat Dis. 2021;17(5):968–75. https://doi.org/10.1016/j.soard.2021.01.010 .
doi: 10.1016/j.soard.2021.01.010 pubmed: 33619007
Plamper A, Lingohr P, Nadal J, et al. A long-term comparative study between one anastomosis gastric bypass and sleeve gastrectomy. J Gastrointest Surg. 2023;27(1):47–55. https://doi.org/10.1007/s11605-022-05515-6 .
doi: 10.1007/s11605-022-05515-6 pubmed: 36376721
Neuberg M, Blanchet MC, Gignoux B, et al. Long-term outcomes after one-anastomosis gastric bypass (OAGB) in morbidly obese patients. Obes Surg. 2020;30(4):1379–84. https://doi.org/10.1007/s11695-019-04287-4 .
doi: 10.1007/s11695-019-04287-4 pubmed: 31760607
Mahawar KK, Parmar C, Graham Y. One anastomosis gastric bypass: key technical features, and prevention and management of procedure-specific complications. Minerva Chir. 2019;74(2):126–36. https://doi.org/10.23736/S0026-4733.18.07844-6 .
doi: 10.23736/S0026-4733.18.07844-6 pubmed: 30019880
De Luca M, Piatto G, Merola G, et al. IFSO update position statement on one anastomosis gastric bypass (OAGB). Obes Surg. 2021;31(7):3251–78. https://doi.org/10.1007/s11695-021-05413-x .
doi: 10.1007/s11695-021-05413-x pubmed: 33939059
Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276–80. https://doi.org/10.1381/096089201321336584 .
doi: 10.1381/096089201321336584 pubmed: 11433900
Haddad A, Kow L, Herrera MF, et al. Innovative bariatric procedures and ethics in bariatric surgery: the IFSO position statement. Obes Surg. 2022;32(10):3217–30. https://doi.org/10.1007/s11695-022-06220-8 .
doi: 10.1007/s11695-022-06220-8 pubmed: 35922610
Ghiassi S, Nimeri A, Aleassa EM, et al. American Society for Metabolic and Bariatric Surgery Clinical Issues Committee. American Society for Metabolic and Bariatric Surgery position statement on one-anastomosis gastric bypass. Surg Obes Relat Dis. 2023;S1550–7289(23):00793–1. https://doi.org/10.1016/j.soard.2023.11.003 .
doi: 10.1016/j.soard.2023.11.003
De Luca M, Tie T, Ooi G, et al. Mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB)-IFSO position statement. Obes Surg. 2018;28(5):1188–206. https://doi.org/10.1007/s11695-018-3182-3 .
doi: 10.1007/s11695-018-3182-3 pubmed: 29600339
Kermansaravi M, DavarpanahJazi AH, ShahabiShahmiri S, et al. Areas of non-consensus around one anastomosis/mini gastric bypass (OAGB/MGB): a narrative review. Obes Surg. 2021;31(6):2453–63. https://doi.org/10.1007/s11695-021-05276-2 .
doi: 10.1007/s11695-021-05276-2 pubmed: 33598845
Salgaonkar, H., Sharples, A., Marimuthu, K., Rao, V., Balaji, N. One Anastomosis Gastric Bypass (OAGB). In: Lomanto, D., Chen, W.TL., Fuentes, M.B. (eds) Mastering endo-laparoscopic and thoracoscopic surgery. Springer, Singapore 2023. https://doi.org/10.1007/978-981-19-3755-2_43
Schäfer A, Gehwolf P, Kienzl-Wagner K, et al. Linear or circular: anastomotic ulcer after gastric bypass surgery. Surg Endosc. 2022;36(5):3011–8. https://doi.org/10.1007/s00464-021-08597-6 .
doi: 10.1007/s00464-021-08597-6 pubmed: 34152456
Ayuso SA, Robinson JN, Okorji LM, et al. Why size matters: an evaluation of gastric pouch size in roux-en-Y gastric bypass using CT volumetric analysis and its effect on marginal ulceration. Obes Surg. 2022;32(3):587–92. https://doi.org/10.1007/s11695-021-05850-8 .
doi: 10.1007/s11695-021-05850-8 pubmed: 34985616
Slagter N, van Wilsum M, de Heide LJM, et al. Laparoscopic small bowel length measurement in bariatric surgery using a hand-over-hand technique with marked graspers: an ex vivo experiment. Obes Surg. 2022;32(4):1201–8. https://doi.org/10.1007/s11695-022-05918-z .
doi: 10.1007/s11695-022-05918-z pubmed: 35201571 pmcid: 8933352
Muise ED, Tackett JJ, Callender KA, et al. Accurate assessment of bowel length: the method of measurement matters. J Surg Res. 2016;206(1):146–50. https://doi.org/10.1016/j.jss.2016.07.022 .
doi: 10.1016/j.jss.2016.07.022 pubmed: 27916354
Tacchino RM. Bowel length: measurement, predictors, and impact on bariatric and metabolic surgery. Surg Obes Relat Dis. 2015;11(2):328–34. https://doi.org/10.1016/j.soard.2014.09.016 .
doi: 10.1016/j.soard.2014.09.016 pubmed: 25614357
Ramos AC, Chevallier JM, Mahawar K, et al. IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): results of a modified Delphi study. Obes Surg. 2020;30(5):1625–34. https://doi.org/10.1007/s11695-020-04519-y .
doi: 10.1007/s11695-020-04519-y pubmed: 32152841
Felsenreich DM, Langer FB, Eichelter J, et al. Bariatric surgery-how much malabsorption do we need?-a review of various limb lengths in different gastric bypass procedures. J Clin Med. 2021;10(4):674. https://doi.org/10.3390/jcm10040674 .
doi: 10.3390/jcm10040674 pubmed: 33578635 pmcid: 7916324
Soong TC, Almalki OM, Lee WJ, et al. Measuring the small bowel length may decrease the incidence of malnutrition after laparoscopic one-anastomosis gastric bypass with tailored bypass limb. Surg Obes Relat Dis. 2019;15(10):1712–8. https://doi.org/10.1016/j.soard.2019.08.010 .
doi: 10.1016/j.soard.2019.08.010 pubmed: 31558409
Salman MA, Salman A, Assal MM, et al. One anastomosis gastric bypass (OAGB) with a 150-cm biliopancreatic limb (BPL) versus a 200-cm BPL, a systematic review and meta-analysis. Obes Surg. 2023;33(6):1846–56. https://doi.org/10.1007/s11695-023-06556-9 .
doi: 10.1007/s11695-023-06556-9 pubmed: 37022609 pmcid: 10234867
Parmar CD, Bryant C, Luque-de-Leon E, et al. One anastomosis gastric bypass in morbidly obese patients with BMI ≥ 50 kg/m
doi: 10.1007/s11695-019-04034-9 pubmed: 31250385
Komaei I, Sarra F, Lazzara C, et al. One anastomosis gastric bypass-mini gastric bypass with tailored biliopancreatic limb length formula relative to small bowel length: preliminary results. Obes Surg. 2019;29(9):3062–70. https://doi.org/10.1007/s11695-019-04019-8 .
doi: 10.1007/s11695-019-04019-8 pubmed: 31209832
Slagter N, de Heide LJM, Jutte EH, et al. Tailoring limb length based on total small bowel length in one anastomosis gastric bypass surgery (TAILOR study): study protocol for a randomized controlled trial. Trials. 2022;23(1):526. https://doi.org/10.1186/s13063-022-06456-w . (Published 2022 Jun 22).
doi: 10.1186/s13063-022-06456-w pubmed: 35733198 pmcid: 9214974

Auteurs

Adam Abu-Abeid (A)

Division of General Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64230906, Tel Aviv, Israel. adamabuabeid@gmail.com.

Jonathan Benjamin Yuval (JB)

Division of General Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64230906, Tel Aviv, Israel.

Andrei Keidar (A)

Division of General Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64230906, Tel Aviv, Israel.

Eran Nizri (E)

Division of General Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64230906, Tel Aviv, Israel.

Guy Lahat (G)

Division of General Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64230906, Tel Aviv, Israel.

Shai Meron Eldar (SM)

Division of General Surgery, Tel Aviv Sourasky Medical Center, Sackler Faculty of Medicine, Tel Aviv University, 6 Weizman Street, 64230906, Tel Aviv, Israel.

Classifications MeSH