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Banded One-Anastomosis Gastric Bypass (BOAGB) for Patients Living with Obesity and Extreme Obesity: A Single Institution’s Experience

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Abstract

Background

The prevalence of patients suffering from extreme obesity (body mass index (BMI) ≥ 50) has significantly increased over the past three decades, surpassing the rise in the general population of overweight patients. Weight loss outcomes after bariatric surgery in patients suffering from extreme obesity are less favorable, with a higher incidence of weight regain. Variations of existing bariatric procedures have been proposed to address this issue. One such variation is adding a gastric band to limit the expansion of the newly created pouch. Limited data exist regarding the effectiveness of this procedure, called the banded one-anastomosis gastric bypass (BOAGB) procedure, compared to other bariatric procedures.

Method

In this retrospective study, we compared all patients who underwent the BOAGB procedure at the Bariatric Surgery Unit in our Medical Center with a postoperative follow-up of at least 1 year with patients who underwent a one-anastomosis gastric bypass (OAGB) or sleeve gastrectomy (SG) procedures. Data collected included demographics, comorbidities, surgical outcomes, complications, and postoperative quality-of-life assessments.

Results

One hundred eleven patients were enlisted to our study during the relevant study period—24 patients underwent the BOAGB procedure, 43 underwent OAGB, and 44 underwent a SG. Lost to follow-up beyond 30 days was 9% (at 1-year post-surgery, we were able to establish contact with 101 patients). The pre-op BMI was significantly higher in the BOAGB group compared to the other procedures. Additionally, a higher prevalence of diabetes was observed in the BOAGB group. The duration of surgery was significantly longer for the BOAGB procedure. No significant differences were found in surgical complications. Overall, all procedures resulted in significant excess weight loss (EWL) or change in BMI, improvement in comorbidities, and improved quality of life postoperatively.

Conclusions

The BOAGB procedure, like OAGB and SG, demonstrated favorable weight loss outcomes and weight maintenance 1 year postoperatively without significant differences between the procedures. The BOAGB procedure is relatively new, with good bariatric outcomes and a favorable safety profile. Long-term study is needed to evaluate these various bariatric procedures’ efficacy further.

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Authors and Affiliations

  1. Department of General Surgery B, Soroka University Medical Center, Beer Sheba, Israel

    Elchanan Quint, Nur Elkrinawi, Ivan Kukeev, David Czeiger, Alex Vakhrushev, Gilbert Sebbag & Oleg Dukhno

  2. Bariatric Surgery Unit, Soroka University Medical Center, The Faculty of Health Sciences, Ben Gurion University of the Negev, Beer Sheba, Israel

    Zvi H. Perry, Alex Vakhrushev & Oleg Dukhno

  3. Department of General Surgery A, Soroka University Medical Center, Beer Sheba, Israel

    Zvi H. Perry

Authors
  1. Elchanan Quint
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  2. Zvi H. Perry
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  3. Nur Elkrinawi
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Correspondence to Zvi H. Perry.

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Ethics Approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study."

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Key Points

• Studies in surgical solutions for patients suffering from severe obesity are lacking, as is seen in solutions for patients living with a BMI>50.

• We aimed to examine mid-term outcomes of banded one-anastomosis gastric bypass (BOAGB), including the effect on quality of life (QOL).

• BOAGB surgery resulted in similar outcomes to those seen in OAGB or lap sleeve gastrectomy (LSG) patients as measured by the Bariatric Analysis and Reporting Outcome System (BAROS).

• BOAGB should be considered when trying to optimize procedures for patients suffering from severe obesity.

Elchanan Quint and Zvi H. Perry are equal contributors.

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Quint, E., Perry, Z.H., Elkrinawi, N. et al. Banded One-Anastomosis Gastric Bypass (BOAGB) for Patients Living with Obesity and Extreme Obesity: A Single Institution’s Experience. OBES SURG 34, 1756–1763 (2024). https://doi.org/10.1007/s11695-024-07194-5

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