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IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): Results of a Modified Delphi Study

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Abstract

Background

One-anastomosis gastric bypass (OAGB-MGB) is currently the third performed primary bariatric surgical procedure worldwide. However, the procedure is hampered by numerous controversies and there is considerable variability in surgical technique, patient selection, and pre- and postoperative care among the surgeons performing this procedure. This paper reports the results of a modified Delphi consensus study organized by the International Federation for Surgery of Obesity and Metabolic Disorders (IFSO).

Methods

Fifty-two internationally recognized bariatric experts from 28 countries convened for voting on 90 consensus statements over two rounds to identify those on which consensus could be reached. Inter-voter agreement of ≥ 70% was considered consensus, with voting participation ≥ 80% considered a robust vote.

Results

At least 70% consensus was achieved for 65 of the 90 questions (72.2% of the items), 61 during the first round of voting and an additional four in the second round. Where consensus was reached on a binary agree/disagree or yes/no item, there was agreement with the statement presented in 53 of 56 instances (94.6%). Where consensus was reached on a statement where options favorable versus unfavorable to OAGB-MGB were provided, including statements in which OAGB-MGB was compared to another procedure, the response option favorable to OAGB-MGB was selected in 13 of 23 instances (56.5%).

Conclusion

Although there is general agreement that the OAGB-MGB is an effective and usually safe option for the management of patients with obesity or severe obesity, numerous areas of non-consensus remain in its use. Further empirical data are needed.

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Acknowledgments

Authors would like to thank Ethicon for their financial support to the consensus conference and also to Manuela Mazzarella, IFSO Chief Operating Officer, and Stefania Acanfora, Congress Manager at MCM, for their tireless assistance organizing the consensus conference.

2019 IFSO Consensus Conference Contributors

Mohamed Abou Zeid, Salman Al Sabah, Priscila Antozzi, Moataz Bashah, Ahmad Bashir, Estuardo Behrens, Mohit Bhandari, Aurelio Bottino, Miguel Carbajo, Leonardo Emilio da Silva, Maurizio De Luca, Eric DeMaria, Mohamad Hayssam ElFawal, Mathias A. L. Fobi, Mohammed Khalid Mirza Gari, David E. Hargroder, Glenda Herrera, Kelvin Higa, Jacques Himpens, Gurvinder Singh Jammu, Ali Khammas, Kuldeepak Singh Kular, Muffazal Lakdawala, Laurent Layani, Enrique Luque-de-León, Mario Musella, Francisco Pacheco, Chetan Parmar, Cesare Peraglie, Gerhard Prager, Arun Prasad, Karl P. Rheinwalt, Rui Ribeiro, Maud Robert, Raul Rosenthal, Bassem Safadi, Nasser Sakran, Asim Shabbir, Peter K. Small, Michel Suter, Osama Taha, Craig Taylor, Sergio Verboonen, Cunchuan Wang, Rudolf Weiner, Nick Williams

Author information

Authors and Affiliations

  1. Gastro-Obeso-Center Institute of Metabolic Optimization, São Paulo, Brazil

    Almino C. Ramos

  2. Hopital Européen Georges Pompidou, Paris, France

    Jean-Marc Chevallier

  3. Sunderland Royal Hospital, Sunderland, UK

    Kamal Mahawar

  4. Department of Surgery Alfred Health, Monash University, Melbourne, Australia

    Wendy Brown

  5. Adelaide Bariatric Centre, Flinders Private Hospital, Bedford Park, Adelaide, South Australia, Australia

    Lilian Kow

  6. Science Right Research Consulting, London, Ontario, Canada

    Kevin P. White

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

    Scott Shikora

Authors
  1. Almino C. Ramos
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  2. Jean-Marc Chevallier
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  3. Kamal Mahawar
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  4. Wendy Brown
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  5. Lilian Kow
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  6. Kevin P. White
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  7. Scott Shikora
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Consortia

IFSO Consensus Conference Contributors

  • Mohamed Abou Zeid
  • , Salman Al Sabah
  • , Priscila Antozzi
  • , Moataz Bashah
  • , Ahmad Bashir
  • , Estuardo Behrens
  • , Mohit Bhandari
  • , Aurelio Bottino
  • , Miguel Carbajo
  • , Leonardo Emilio da Silva
  • , Maurizio De Luca
  • , Eric DeMaria
  • , Mohamad Hayssam ElFawal
  • , Mathias A. L. Fobi
  • , Mohammed Khalid Mirza Gari
  • , David E. Hargroder
  • , Glenda Herrera
  • , Kelvin Higa
  • , Jacques Himpens
  • , Gurvinder Singh Jammu
  • , Ali Khammas
  • , Kuldeepak Singh Kular
  • , Muffazal Lakdawala
  • , Laurent Layani
  • , Enrique Luque-de-León
  • , Mario Musella
  • , Francisco Pacheco
  • , Chetan Parmar
  • , Cesare Peraglie
  • , Gerhard Prager
  • , Arun Prasad
  • , Karl P. Rheinwalt
  • , Rui Ribeiro
  • , Maud Robert
  • , Raul Rosenthal
  • , Bassem Safadi
  • , Nasser Sakran
  • , Asim Shabbir
  • , Peter K. Small
  • , Michel Suter
  • , Osama Taha
  • , Craig Taylor
  • , Sergio Verboonen
  • , Cunchuan Wang
  • , Rudolf Weiner
  •  & Nick Williams

Corresponding author

Correspondence to Almino C. Ramos.

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Conflict of Interest

The authors declare that they have no conflicts of interest.

Ethics Statement

The current study was a survey of expert surgeons and hence did not involve patients or animal subjects.

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Ramos, A.C., Chevallier, JM., Mahawar, K. et al. IFSO (International Federation for Surgery of Obesity and Metabolic Disorders) Consensus Conference Statement on One-Anastomosis Gastric Bypass (OAGB-MGB): Results of a Modified Delphi Study. OBES SURG 30, 1625–1634 (2020). https://doi.org/10.1007/s11695-020-04519-y

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  • DOI: https://doi.org/10.1007/s11695-020-04519-y

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