Advertisement

Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Mini Gastric Bypass-One Anastomosis Gastric Bypass (MGB-OAGB)-IFSO Position Statement

Preamble

The International Federation for the Surgery of Obesity and Metabolic Disorders (IFSO) has played an integral role in educating both the metabolic surgical and the medical community at large about the role of innovative and new surgical and/or endoscopic interventions in treating adiposity-based chronic diseases.

The mini gastric bypass is also known as the one anastomosis gastric bypass. The IFSO has agreed that the standard nomenclature should be the mini gastric bypass-one anastomosis gastric bypass (MGB-OAGB). The IFSO commissioned a task force (Appendix 1) to determine if MGB-OAGB is an effective and safe procedure and if it should be considered a surgical option for the treatment of obesity and metabolic diseases.

The following position statement is issued by the IFSO MGB-OAGB task force and approved by the IFSO Scientific Committee and Executive Board. This statement is based on current clinical knowledge, expert opinion, and published peer-reviewed scientific evidence. It will be reviewed in 2 years.

This is a preview of subscription content, log in to check access.

Fig. 1

References

  1. 1.

    Mason EE, Ito C. Gastric bypass in obesity. Surg Clin North Am. 1967;47(6):1345–51.

  2. 2.

    Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg. 2001;11(3):276–80.

  3. 3.

    Carbajo M, García-Caballero M, Toledano M, et al. One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005;15(3):398–404.

  4. 4.

    Lee WJ, Lin YH. Single-anastomosis gastric bypass (SAGB): appraisal of clinical evidence. Obes Surg. 2014;24(10):1749–56.

  5. 5.

    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.

  6. 6.

    Musella M, Milone M. Still "controversies" about the mini gastric bypass? Obes Surg. 2014;24(4):643–4.

  7. 7.

    Angrisani, L., et al., Bariatric surgery and Endoluminal procedures: IFSO worldwide survey 2014. Obes Surg, 2017.

  8. 8.

    Blanc P, Lointier P, Breton C, et al. The hand-sewn anastomosis with an absorbable bidirectional monofilament barbed suture Stratafix during laparoscopic one anastomosis loop gastric bypass. Retrospective study in 50 patients. Obes Surg. 2015;25(12):2457–60.

  9. 9.

    Blanchet MC, Gignoux B, Matussière Y, et al. Experience with an enhanced recovery after surgery (ERAS) program for bariatric surgery: comparison of MGB and LSG in 374 patients. Obes Surg. 2017;27(7):1896–900.

  10. 10.

    Celik A, Pouwels S, Karaca FC, et al. Time to glycemic control—an observational study of 3 different operations. Obes Surg. 2017;27(3):694–702.

  11. 11.

    Dardzinska JA et al. Fasting and post-prandial peptide YY levels in obese patients before and after mini versus roux-en-Y gastric bypass. Minerva Chir. 2017;72(1):24–30.

  12. 12.

    Garcia-Caballero M et al. Resolution of diabetes mellitus and metabolic syndrome in normal weight 24-29 BMI patients with one anastomosis gastric bypass. Nutricion Hospitalaria. 2012;27(2):623–31.

  13. 13.

    Genser L, Carandina S, Tabbara M, et al. Presentation and surgical management of leaks after mini-gastric bypass for morbid obesity. Surgery for Obesity & Related Diseases. 2016;12(2):305–12.

  14. 14.

    Greco, F. and R. Tacchino, Ileal food diversion: a simple, powerful and easily revisable and reversible single-anastomosis gastric bypass. Obes Surg, 2014. 19.

  15. 15.

    Kaska L, Proczko M, Wiśniewski P, et al. A prospective evaluation of the influence of three bariatric procedures on insulin resistance improvement. Should the extent of undiluted bile transit be considered a key postoperative factor altering glucose metabolism? Wideochir Inne Tech Maloinwazyjne. 2015;10(2):213–28.

  16. 16.

    Kim MJ, Park HK, Byun DW, et al. Incretin levels 1 month after laparoscopic single anastomosis gastric bypass surgery in non-morbid obese type 2 diabetes patients. Asian Journal of Surgery. 2014;37(3):130–7.

  17. 17.

    Kim Z, Hur KY. Laparoscopic mini-gastric bypass for type 2 diabetes: the preliminary report. World J Surg. 2011;35(3):631–6.

  18. 18.

    Meydan C, Raziel A, Sakran N, et al. Single anastomosis gastric bypass-comparative short-term outcome study of conversional and primary procedures. Obes Surg. 2017;27(2):432–8.

  19. 19.

    Mokhber S et al. Anemia outcome after laparascopic mini bypass: analysis of 107 consecutive patients. Acta Gastroenterol Belg. 2016;79(2):201–5.

  20. 20.

    Noun R, Riachi E, Zeidan S, et al. Mini-gastric bypass by mini-laparotomy: a cost-effective alternative in the laparoscopic era. Obes Surg. 2007;17(11):1482–6.

  21. 21.

    Piazza L, di Stefano C, Ferrara F, et al. Revision of failed primary adjustable gastric banding to mini-gastric bypass: results in 48 consecutive patients. Updat Surg. 2015;67(4):433–7.

  22. 22.

    Shenouda, M.M., et al., Bile gastritis following laparoscopic single anastomosis gastric bypass: pilot study to assess significance of bilirubin level in gastric aspirate. Obes Surg, 2017.

  23. 23.

    Ahmetasevic E et al. Bariatric surgery in university clinic center Tuzla—results after 30 operations. Acta Inform Med. 2016;24(2):139–42.

  24. 24.

    Betry C et al. Need for intensive nutrition care after bariatric surgery. JPEN J Parenter Enteral Nutr. 2017;41(2):258–62.

  25. 25.

    Garciacaballero M et al. Improvement of C peptide zero BMI 24-34 diabetic patients after tailored one anastomosis gastric bypass (BAGUA). Nutricion Hospitalaria. 2013;28(Suppl 2):35–46.

  26. 26.

    Greco F. Conversion of vertical sleeve gastrectomy to a functional single-anastomosis gastric bypass: technique and preliminary results using a non-adjustable ring instead of stapled division. Obes Surg. 2017;27(4):896–901.

  27. 27.

    Himpens JM, Vilallonga R, Cadière GB, et al. Metabolic consequences of the incorporation of a roux limb in an omega loop (mini) gastric bypass: evaluation by a glucose tolerance test at mid-term follow-up. Surg Endosc. 2016;30(7):2935–45.

  28. 28.

    Milone M, di Minno MN, Leongito M, et al. Bariatric surgery and diabetes remission: sleeve gastrectomy or mini-gastric bypass? World J Gastroenterol. 2013;19(39):6590–7.

  29. 29.

    Tolone S, Cristiano S, Savarino E, et al. Effects of omega-loop bypass on esophagogastric junction function. Surgery for Obesity & Related Diseases. 2016;12(1):62–9.

  30. 30.

    Yeh C, Huang HH, Chen SC, et al. Comparison of consumption behavior and appetite sensations among patients with type 2 diabetes mellitus after bariatric surgery. PeerJ. 2017;5:e3090.

  31. 31.

    Guo, X., et al., [Impacts of laparoscopic bariatric surgery on GLP-1 and Ghrelin level in patients with type 2 diabetes mellitus]. Chung-Hua Wai Ko Tsa Chih [Chinese Journal of Surgery], 2013. 51(4): p. 323–7.

  32. 32.

    Guo X, Yin K, Zhuo GZ, et al. Efficacy comparison between 2 methods of laparoscopic gastric bypass surgery in the treatment of type 2 diabetes mellitus. Zhonghua Weichang Waike Zazhi. 2012;15(11):1125–8.

  33. 33.

    Ding D, Chen DL, Hu XG, et al. Outcomes after laparoscopic surgery for 219 patients with obesity. Zhonghua Weichang Waike Zazhi. 2011;14(2):128–31.

  34. 34.

    Lee WJ, Yu PJ, Wang W, et al. Laparoscopic roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity: a prospective randomized controlled clinical trial. Ann Surg. 2005;242(1):20–8.

  35. 35.

    Darabi S, Talebpour M, Zeinoddini A, et al. Laparoscopic gastric plication versus mini-gastric bypass surgery in the treatment of morbid obesity: a randomized clinical trial. Surgery for Obesity & Related Diseases. 2013;9(6):914–9.

  36. 36.

    Lee WJ, Chong K, Lin YH, et al. Laparoscopic sleeve gastrectomy versus single anastomosis (mini-) gastric bypass for the treatment of type 2 diabetes mellitus: 5-year results of a randomized trial and study of incretin effect. Obes Surg. 2014;24(9):1552–62.

  37. 37.

    Seetharamaiah S, Tantia O, Goyal G, et al. LSG vs OAGB-1 year follow-up data-a randomized control trial. Obes Surg. 2017;27(4):948–54.

  38. 38.

    Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15(9):1304–8.

  39. 39.

    Noun R, Zeidan S. Laparoscopic mini-gastric bypass: an effective option for the treatment of morbid obesity. J Chir. 2007;144(4):301–4.

  40. 40.

    Peraglie C. Laparoscopic mini-gastric bypass (LMGB) in the super-super obese: outcomes in 16 patients. Obes Surg. 2008;18(9):1126–9.

  41. 41.

    Lee WJ, Wang W, Lee YC, et al. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008;18(3):294–9.

  42. 42.

    Lee WJ, Wang W, Lee YC, et al. Effect of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: comparison of BMI>35 and <35 kg/m2. J Gastrointest Surg. 2008;12(5):945–52.

  43. 43.

    Piazza L, Ferrara F, Leanza S, et al. Laparoscopic mini-gastric bypass: short-term single-institute experience. Updat Surg. 2011;63(4):239–42.

  44. 44.

    Lee WJ, Ser KH, Lee YC, et al. Laparoscopic roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity: a 10-year experience. Obes Surg. 2012;22(12):1827–34.

  45. 45.

    Lee YC, Lee WJ, Liew PL. Predictors of remission of type 2 diabetes mellitus in obese patients after gastrointestinal surgery. Obesity Research & Clinical Practice. 2013;7(6):e494–500.

  46. 46.

    Lee YC, Liew PL, Lee WJ, et al. Gastrointestinal quality of life following bariatric surgery in Asian patients. Hepato-Gastroenterology. 2013;60(124):759–61.

  47. 47.

    Carbajo MA, Jiménez JM, Castro MJ, et al. Outcomes in weight loss, fasting blood glucose and glycosylated hemoglobin in a sample of 415 obese patients, included in the database of the European accreditation council for excellence centers for bariatric surgery with laparoscopic one anastomosis gastric bypass. Nutricion Hospitalaria. 2014;30(5):1032–8.

  48. 48.

    Kim MJ, Hur KY. Short-term outcomes of laparoscopic single anastomosis gastric bypass (LSAGB) for the treatment of type 2 diabetes in lower BMI (<30 kg/m(2)) patients. Obes Surg. 2014;24(7):1044–51.

  49. 49.

    Kular KS, Manchanda N, Rutledge R. A 6-year experience with 1,054 mini-gastric bypasses-first study from Indian subcontinent. Obes Surg. 2014;24(9):1430–5.

  50. 50.

    Musella, M., et al., A decade of bariatric surgery. What have we learned? Outcome in 520 patients from a single institution. International Journal Of Surgery, 2014. 12 Suppl 1: p. S183–8.

  51. 51.

    Musella M, Susa A, Greco F, et al. The laparoscopic mini-gastric bypass: the Italian experience: outcomes from 974 consecutive cases in a multicenter review. Surg Endosc. 2014;28(1):156–63.

  52. 52.

    Yang PJ, Lee WJ, Tseng PH, et al. Bariatric surgery decreased the serum level of an endotoxin-associated marker: lipopolysaccharide-binding protein. Surgery for Obesity & Related Diseases. 2014;10(6):1182–7.

  53. 53.

    Garcia-Caballero M et al. Super obese behave different from simple and morbid obese patients in the changes of body composition after tailored one anastomosis gastric bypass (BAGUA). Nutricion Hospitalaria. 2014;29(5):1013–9.

  54. 54.

    Luger M, Kruschitz R, Langer F, et al. Effects of omega-loop gastric bypass on vitamin D and bone metabolism in morbidly obese bariatric patients. Obes Surg. 2015;25(6):1056–62.

  55. 55.

    Milone M, Lupoli R, Maietta P, et al. Lipid profile changes in patients undergoing bariatric surgery: a comparative study between sleeve gastrectomy and mini-gastric bypass. Int J Surg. 2015;14:28–32.

  56. 56.

    Kular KS, Manchanda N, Cheema GK. Seven years of mini-gastric bypass in type II diabetes patients with a body mass index <35 kg/m(2). Obes Surg. 2016;26(7):1457–62.

  57. 57.

    Peraglie C. Laparoscopic mini-gastric bypass in patients age 60 and older. Surg Endosc. 2016;30(1):38–43.

  58. 58.

    Al-Shurafa H et al. Primary experience of bariatric surgery in a newly established private obesity center. Saudi Medical Journal. 2016;37(10):1089–95.

  59. 59.

    Jammu GS, Sharma R. A 7-year clinical audit of 1107 cases comparing sleeve gastrectomy, roux-en-Y gastric bypass, and mini-gastric bypass, to determine an effective and safe bariatric and metabolic procedure. Obes Surg. 2016;26(5):926–32.

  60. 60.

    Kansou, G., et al., Laparoscopic sleeve gastrectomy versus laparoscopic mini gastric bypass: One year outcomes. International Journal Of Surgery, 2016. 33 Pt A: p. 18–22.

  61. 61.

    Kruschitz R, Luger M, Kienbacher C, et al. The effect of roux-en-Y vs. Omega-loop gastric bypass on liver, metabolic parameters, and weight loss. Obes Surg. 2016;26(9):2204–12.

  62. 62.

    Musella M, Apers J, Rheinwalt K, et al. Efficacy of bariatric surgery in type 2 diabetes mellitus remission: the role of mini gastric bypass/one anastomosis gastric bypass and sleeve Gastrectomy at 1 year of follow-up. A European survey Obesity Surgery. 2016;26(5):933–40.

  63. 63.

    Karimi, M., et al., Trend of changes in serum albumin and its relation with sex, age, and BMI following laparoscopic mini-gastric bypass surgery in morbid obese cases. Obes Surg, 2017.

  64. 64.

    Carbajo M, García-Caballero M, Toledano M, et al. One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005;15(3):398–404.

  65. 65.

    Wang W, Wei PL, Lee YC, et al. Short-term results of laparoscopic mini-gastric bypass. Obes Surg. 2005;15(5):648–54.

  66. 66.

    Chakhtoura G, Zinzindohoué F, Ghanem Y, et al. Primary results of laparoscopic mini-gastric bypass in a French obesity-surgery specialized university hospital. Obes Surg. 2008;18(9):1130–3.

  67. 67.

    Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22(5):697–703.

  68. 68.

    Disse E, Pasquer A, Espalieu P, et al. Greater weight loss with the omega loop bypass compared to the roux-en-Y gastric bypass: a comparative study. Obes Surg. 2014;24(6):841–6.

  69. 69.

    Bruzzi M, Rau C, Voron T, et al. Single anastomosis or mini-gastric bypass: long-term results and quality of life after a 5-year follow-up. Surgery for Obesity & Related Diseases. 2015;11(2):321–6.

  70. 70.

    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.

  71. 71.

    Guenzi M, Arman G, Rau C, et al. Remission of type 2 diabetes after omega loop gastric bypass for morbid obesity. Surg Endosc. 2015;29(9):2669–74.

  72. 72.

    Parmar CD, Mahawar KK, Boyle M, et al. Mini gastric bypass: first report of 125 consecutive cases from United Kingdom. Clinical Obesity. 2016;6(1):61–7.

  73. 73.

    Madhok B, Mahawar KK, Boyle M, et al. Management of super-super obese patients: comparison between mini (one anastomosis) gastric bypass and sleeve gastrectomy. Obes Surg. 2016;26(7):1646–9.

  74. 74.

    Carbajo MA, Luque-de-León E, Jiménez JM, et al. Laparoscopic one-anastomosis gastric bypass: technique, results, and long-term follow-up in 1200 patients. Obes Surg. 2017;27(5):1153–67.

  75. 75.

    Carbajo MA, Fong-Hirales A, Luque-de-León E, et al. Weight loss and improvement of lipid profiles in morbidly obese patients after laparoscopic one-anastomosis gastric bypass: 2-year follow-up. Surg Endosc. 2017;31(1):416–21.

  76. 76.

    Lessing Y, Pencovich N, Khatib M, et al. One-anastomosis gastric bypass: first 407 patients in 1 year. Obes Surg. 2017;27:2583–9.

  77. 77.

    Musella M, Susa A, Manno E, et al. Complications following the mini/one anastomosis gastric bypass (MGB/OAGB): a multi-institutional survey on 2678 patients with a mid-term (5 years) follow-up. Obes Surg. 2017;27:2956–67.

  78. 78.

    Taha O, Abdelaal M, Abozeid M, et al. Outcomes of omega loop gastric bypass, 6-years experience of 1520 cases. Obes Surg. 2017;27(8):1952–60.

  79. 79.

    Wang W, Huang MT, Wei PL, et al. Laparoscopic mini-gastric bypass for failed vertical banded gastroplasty. Obes Surg. 2004;14(6):777–82.

  80. 80.

    Moszkowicz D, Rau C, Guenzi M, et al. Laparoscopic omega-loop gastric bypass for the conversion of failed sleeve gastrectomy: early experience. Journal of visceral surgery. 2013;150(6):373–8.

  81. 81.

    Bruzzi M, Voron T, Zinzindohoue F, et al. Revisional single-anastomosis gastric bypass for a failed restrictive procedure: 5-year results. Surgery for Obesity & Related Diseases. 2016;12(2):240–5.

  82. 82.

    Salama TM, Sabry K. Redo surgery after failed open VBG: laparoscopic Minigastric bypass versus laparoscopic roux en Y gastric bypass-which is better? Minim Invasive Surg. 2016;2016:8737519.

  83. 83.

    Ghosh S, Bui TL, Skinner CE, et al. A 12-month review of Revisional single anastomosis gastric bypass for complicated laparoscopic adjustable gastric banding for body mass index over 35. Obes Surg. 2017;27:3048–54.

  84. 84.

    Chansaenroj P, Aung L, Lee WJ, et al. Revision procedures after failed adjustable gastric banding: comparison of efficacy and safety. Obes Surg. 2017;27:2861–7.

  85. 85.

    Chen CY, Lee WJ, Lee HM, et al. Laparoscopic conversion of gastric bypass complication to sleeve gastrectomy: technique and early results. Obes Surg. 2016;26(9):2014–21.

  86. 86.

    Chen MC, Lee YC, Lee WJ, et al. Diet behavior and low hemoglobin level after laparoscopic mini-gastric bypass surgery. Hepato-Gastroenterology. 2012;59(120):2530–2.

  87. 87.

    Chiu CC, Lee WJ, Wang W, et al. Prevention of trocar-wound hernia in laparoscopic bariatric operations. Obes Surg. 2006;16(7):913–8.

  88. 88.

    Saarinen T, Räsänen J, Salo J, et al. Bile reflux scintigraphy after mini-gastric bypass. Obes Surg. 2017;27(8):2083–9.

  89. 89.

    Lee WJ, Lee YC, Ser KH, et al. Revisional surgery for laparoscopic minigastric bypass. Surgery for Obesity & Related Diseases. 2011;7(4):486–91.

  90. 90.

    Mahawar KK, Reed AN, Graham YNH. Marginal ulcers after one anastomosis (mini) gastric bypass: a survey of surgeons. Clin Obes. 2017;7(3):151–6.

  91. 91.

    Mishra T, Lakshmi KK, Peddi KK. Prevalence of cholelithiasis and choledocholithiasis in morbidly obese south Indian patients and the further development of biliary calculus disease after sleeve gastrectomy, gastric bypass and mini gastric bypass. Obes Surg. 2016;26(10):2411–7.

  92. 92.

    Rutledge R. Hospitalization before and after mini-gastric bypass surgery. Int J Surg. 2007;5(1):35–40.

  93. 93.

    Salama TMS, Hassan MI. Incidence of biliary reflux esophagitis after laparoscopic omega loop gastric bypass in morbidly obese patients. J Laparoendosc Adv Surg Tech A. 2017;27(6):618–22.

Download references

Author information

Correspondence to Wendy A. Brown.

Ethics declarations

Conflict Statement

Dr. De Luca has nothing to disclose. Ms. Tie reports personal fees from Centre for Obesity Research and Education (CORE), grants from Apollo Endosurgery, grants from Novo Nordisc, outside the submitted work. Dr. Ooi reports personal fees from National Health and Medical Research Council, personal fees from Royal Australasian College of Surgeon, outside the submitted work. Dr. Himpens reports personal fees from Ethicon, personal fees from Medtronic, outside the submitted work. Dr. Higa has nothing to disclose. Dr. Carbajo reports he is the current President of the MGB-OAGB International Club. Dr. Mahawar reports he has been paid honoraria by Medtronic Inc. for mentoring consultant bariatric surgeons in the United Kingdom to help them start them start their One Anastomosis Gastric Bypass programme. Dr Shikora has nothing to disclose. Dr. Brown reports grants from Johnson and Johnson, grants from Medtronic, grants from GORE, personal fees from GORE, grants from Applied Medical, grants from Apollo Endosurgery, grants and personal fees from Novo Nordisc, personal fees from Merck Sharpe and Dohme, outside the submitted work.

Ethics Statement

Ethical approval is not required for this type of study.

Informed Consent

Informed consent is not required for this study.

Additional information

On behalf of the IFSO appointed task force reviewing the literature on MGB-OAGB

Appendix 1—Members of the IFSO Appointed Task Force Reviewing the Literature on MGB-OAGB

Appendix 1—Members of the IFSO Appointed Task Force Reviewing the Literature on MGB-OAGB

Maurizio De Luca—Italy

Kelvin Higa—USA

Tiffany Tie—Australia

Geraldine Ooi—Australia

Wendy Brown—Australia

Jacques Himpens—Belgium

Scott Shikora—USA

Rudolf Weiner—Germany

Miguel-A Carbajo—Spain

Kamal Mahawar—UK

Jean Marc Chevallier—France

Luigi Angrisani—Italy

Luque-de-Leon—Spain

Aparna G Bhasker—India

Alberto Sartori—Italy

Mario Musella—Italy

KS Kular—India

Emanuele Soricelli—Italy

Ramon VilallongaVilallonga—Spain

Muffazal Lakdawala—India

Enrico Facchiano—Italy

Alessio Corradi—Germany

Appendix 2

Table 4 List of search terms used

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

De Luca, M., Tie, T., Ooi, G. et al. Mini Gastric Bypass-One Anastomosis Gastric Bypass (MGB-OAGB)-IFSO Position Statement. OBES SURG 28, 1188–1206 (2018). https://doi.org/10.1007/s11695-018-3182-3

Download citation

Keywords

  • MGB OAGB IFSO Position statement Systematic Review