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Laparoscopic One Anastomosis Gastric Bypass (OAGB)/Mini Gastric Bypass (MGB): OAGB Technique

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Obesity, Bariatric and Metabolic Surgery

Abstract

One-anastomosis gastric bypass (OAGB) and mini-gastric bypass (MGB) is increasing exponentially worldwide. OAGB was developed in the year 2002. Although it shares some principles with MGB, such as creating only one anastomosis and avoiding an alimentary (Roux) limb, OAGB has progressively introduced several technical concepts and contrasting proposals. Among others, these include: (1) Complete small bowel (SB) measurement to determine biliopancreatic limb (BPL) and common channel (CCh) lengths, which are not fixed but calculated according to total SB length, body mass index (BMI), age, and other metabolic variables; (2) Dissection of the Angle of His and esophagogastric junction (EGJ) membrane with complete visualization of left and right crus and selective hiatoplasty, followed by the creation of a very long and narrow gastric pouch; (3) An anti-reflux mechanism, constructed by an ~10 cm latero-lateral continuous suture between the chosen SB and the distal part of the gastric pouch; and (4) Latero-lateral gastroenteric anastomosis of ~2.5 cm [wider than in Roux-Y Gastric Bypass (RYGB)], but not as wide as in MGB. Applying these measures in a considerable number of patients has resulted in a more robust operation with an excellent balance between safety and efficacy in the long-term outcomes analysis. Some groups perform “hybrid” procedures that include only some of the OAGB principles, and these have also slightly changed through the years. Since outcomes rely highly on its proper performance, this chapter presents a step-by-step description of the standardized current OAGB.

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Abbreviations

BMI:

Body mass index

BPL:

Biliopancreatic limb

CCh:

Common channel

EGJ:

Esophagogastric junction

MGB:

Mini-gastric bypass

OAGB:

One-anastomosis gastric bypass

RLQ:

Right lower quadrant

RYGB:

Roux-en-Y gastric bypass

SB:

Small bowel

ST:

Surgical Table

WL:

Weight loss

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Author information

Authors and Affiliations

  1. Center of Excellence for the Study and Treatment of Obesity and Diabetes – Latinamerican Affiliated Subsidiary, The American British Cowdray Medical Center, I.A.P., México City, Mexico

    Enrique Luque-de-León

  2. Center of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain

    Miguel A. Carbajo

Authors
  1. Enrique Luque-de-León
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  2. Miguel A. Carbajo
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Corresponding author

Correspondence to Enrique Luque-de-León .

Editor information

Editors and Affiliations

  1. Homerton University Hospital, London, UK

    Sanjay Agrawal

Section Editor information

  1. Sunderland Royal Hospital, Sunderland, UK

    Kamal Mahawar MS, MSc, FRCSEd

  2. University of Sunderland, Sunderland, UK

    Kamal Mahawar MS, MSc, FRCSEd

  3. Department of General and Bariatric Surgery, Whittington Hospital, London, UK

    Chetan Parmar

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Luque-de-León, E., Carbajo, M.A. (2022). Laparoscopic One Anastomosis Gastric Bypass (OAGB)/Mini Gastric Bypass (MGB): OAGB Technique. In: Agrawal, S. (eds) Obesity, Bariatric and Metabolic Surgery. Springer, Cham. https://doi.org/10.1007/978-3-030-54064-7_89-1

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  • DOI: https://doi.org/10.1007/978-3-030-54064-7_89-1

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  • Print ISBN: 978-3-030-54064-7

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