Gastric emptying after a new, more physiological anti-obesity operation: the Magenstrasse and Mill procedure

Abstract.

The Magenstrasse and Mill (M&M) procedure for obesity is designed to preserve normal gastric emptying mechanisms. The hypothesis investigated in this study was that gastric emptying would be normal after the M&M gastroplasty. Gastric emptying studies were performed using both liquid and solid test meals, in ten morbidly obese patients (MO group) and in 13 patients after the M&M procedure (MM group). Seven people of normal weight served as controls and were matched for age, sex and height to the M&M and MO groups. Three years after the M&M procedure, mean (SD) weight loss was 42 (19) kg, with a mean loss of excess weight of 58% (20%). Gastric emptying half-times (t _1/2) are expressed in minutes, as median values (25th and 75th percentiles). The t _1/2 for solids was 97 (85–110) min in the control group, 140 (86–220) min in the MO group and 79 (46–150) min in the MM group. Median gastric emptying for solids was 0.7% (0.6%–0.8%) per minute in the control group, 0.5% (0.3%–0.8%) in the MO group and 0.9% (0.4%–1.4%) in the M&M group. There were no statistically significant differences in the emptying times of the three groups. It is concluded that the M&M procedure achieves acceptable weight loss, while preserving gastric emptying mechanisms and thus minimising possible side-effects such as vomiting, dumping and diarrhoea, which are common complications of gastric bypass procedures.