Obesity Surgery

, Volume 27, Issue 9, pp 2222–2228 | Cite as

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

  • Kamal K. MahawarEmail author
  • Cynthia-Michelle Borg
  • Kuldeepak Singh Kular
  • Michael J. Courtney
  • Karim Sillah
  • William R. J. Carr
  • Neil Jennings
  • Brijesh Madhok
  • Rishi Singhal
  • Peter K. Small
Original Contributions



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.


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


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.


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.


Mini gastric bypass One anastomosis gastric bypass Single anastomosis gastric bypass Omega loop gastric bypass Objections Gastric cancer Oesophageal cancer Bile reflux Malnutrition 



One Anastomosis (Mini) Gastric Bypass


International Federation for the Surgery of Obesity and Metabolic Disorders


Roux-en-Y gastric bypass


Gastro-oesophageal reflux disease


Compliance with Ethical Standards

Conflict of Interest Statement

The authors declare that they have no conflict of interest.

Statement of Human and Animal Rights

Not applicable.

Statement of Informed Consent

Not applicable.

Source(s) of Funding



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Copyright information

© Springer Science+Business Media New York 2017

Authors and Affiliations

  • Kamal K. Mahawar
    • 1
    Email author
  • Cynthia-Michelle Borg
    • 2
  • Kuldeepak Singh Kular
    • 3
  • Michael J. Courtney
    • 1
  • Karim Sillah
    • 1
  • William R. J. Carr
    • 1
  • Neil Jennings
    • 1
  • Brijesh Madhok
    • 4
  • Rishi Singhal
    • 5
  • Peter K. Small
    • 1
  1. 1.Bariatric UnitSunderland Royal HospitalSunderlandUK
  2. 2.University Hospital Lewisham, Lewisham and Greenwich NHS TrustLondonUK
  3. 3.Kular HospitalBijaIndia
  4. 4.Royal Derby HospitalDerbyUK
  5. 5.Birmingham Heartlands HospitalBirminghamUK

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