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The First Consensus Statement on One Anastomosis/Mini Gastric Bypass (OAGB/MGB) Using a Modified Delphi Approach

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Abstract

Background

An increasing number of surgeons worldwide are now performing one anastomosis/mini gastric bypass (OAGB/MGB). Lack of a published consensus amongst experts may be hindering progress and affecting outcomes. This paper reports results from the first modified Delphi consensus building exercise on this procedure.

Methods

A committee of 16 recognised opinion-makers in bariatric surgery with special interest in OAGB/MGB was constituted. The committee invited 101 OAGB/MGB experts from 39 countries to vote on 55 statements in areas of controversy or variation associated with this procedure. An agreement amongst ≥ 70.0% of the experts was considered to indicate a consensus.

Results

A consensus was achieved for 48 of the 55 proposed statements after two rounds of voting. There was no consensus for seven statements. Remarkably, 100.0% of the experts felt that OAGB/MGB was an “acceptable mainstream surgical option” and 96.0% felt that it could no longer be regarded as a new or experimental procedure. Approximately 96.0 and 91.0% of the experts felt that OAGB/MGB did not increase the risk of gastric and oesophageal cancers, respectively. Approximately 94.0% of the experts felt that the construction of the gastric pouch should start in the horizontal portion of the lesser curvature. There was a consensus of 82, 84, and 85% for routinely supplementing iron, vitamin B12, and vitamin D, respectively.

Conclusion

OAGB/MGB experts achieved consensus on a number of aspects concerning this procedure but several areas of disagreements persist emphasising the need for more studies in the future.

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Abbreviations

OAGB/MGB:

One Anastomosis (Mini) Gastric Bypass

IFSO:

International Federation for the Surgery of Obesity and Metabolic Disorders

RYGB:

Roux-en-Y Gastric Bypass

GERD:

Gastro-Esophageal Reflux Disease

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Author information

Authors and Affiliations

  1. Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK

    Kamal K. Mahawar & Peter K. Small

  2. St. Pierre University Hospital, Brussels, Belgium

    Jacques Himpens

  3. Brigham and Women’s Hospital, Harvard Medical School, Boston, MA, USA

    Scott A. Shikora

  4. Université Paris 5, Paris, France

    Jean-Marc Chevallier

  5. Digestive Health Institute, Mumbai, India

    Mufazzal Lakdawala

  6. Montebelluna Treviso Hospital, Treviso, Italy

    Maurizio De Luca

  7. Clinic Obesity Surgery, Sana-Klinikum Offenbach, Offenbach, Germany

    Rudolf Weiner

  8. Rashid Hospital, Dubai, United Arab Emirates

    Ali Khammas

  9. Kular College and Hospitals Pvt. Ltd., Bija, Ludhiana, Punjab, India

    Kuldeepak Singh Kular

  10. Advanced Biomedical Sciences Department, Federico II University, Naples, Italy

    Mario Musella

  11. Medical University of Vienna, Vienna, Austria

    Gerhard Prager

  12. King Fahad University Hospital, Khobar, Saudi Arabia

    Mohammad Khalid Mirza

  13. Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain

    Miguel Carbajo

  14. Adelaide Bariatric Centre, Adelaide, Australia

    Lilian Kow

  15. Min-Sheng General Hospital, Taoyuan City, Taiwan

    Wei-Jei Lee

Authors
  1. Kamal K. Mahawar
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  2. Jacques Himpens
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  3. Scott A. Shikora
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  4. Jean-Marc Chevallier
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  5. Mufazzal Lakdawala
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  6. Maurizio De Luca
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  7. Rudolf Weiner
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  8. Ali Khammas
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  9. Kuldeepak Singh Kular
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  10. Mario Musella
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  11. Gerhard Prager
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  12. Mohammad Khalid Mirza
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  13. Miguel Carbajo
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  14. Lilian Kow
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  15. Wei-Jei Lee
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  16. Peter K. Small
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Contributions

KM conceived the idea for this exercise, moderated it, analysed the results, and wrote large sections of the manuscript. All other authors helped with determining the methodology of the exercise, provided feedback at every stage, took part in the voting, critically reviewed the manuscript, and provided leadership. All authors have seen the final draft and approve of it.

Corresponding author

Correspondence to Kamal K. Mahawar.

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Conflict of Interest

The authors declare that they have no conflict of interest. Jacques Himpens is a consultant with Medtronic and with Ethicon.

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Mahawar, K.K., Himpens, J., Shikora, S.A. et al. The First Consensus Statement on One Anastomosis/Mini Gastric Bypass (OAGB/MGB) Using a Modified Delphi Approach. OBES SURG 28, 303–312 (2018). https://doi.org/10.1007/s11695-017-3070-2

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  • DOI: https://doi.org/10.1007/s11695-017-3070-2

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