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Laparoscopic Band-Separated One Anastomosis Gastric Bypass

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Abstract

Background

This video demonstrates laparoscopic band-separated one anastomosis gastric bypass—combining the advantages of banding and gastric bypass without stapler and cutter use. This is basically a gastrojejunal loop bypass above an obstructive band in the upper stomach.

Materials and Surgical Technique

An adjustable low pressure “Medsil” gastric band was introduced in the abdomen and retracted through the retrogastric tunnel. The front wall of the stomach below the band was displaced in the upward direction through the ring band, increasing the size of the anterior portion of the stomach pouch so that a gastroenteroanastomosis could be created at this point. Gastro-gastric sutures were placed to create a gastro-gastric plication around the band and hold it in position. The band tubing was exteriorized and connected to a special port, which was secured to the abdominal wall fascia. A jejunal loop was created about 200 cm from the ligament of Treitz and anastomosed to the gastric pouch by hand using Vicryl 2/0 sutures.

Results

Between November 2015 and February 2016, the study was performed on 10 patients. The average operating time for all cases was 75 min (range 63–87). There was no morbidity or mortality. No complications were observed, including band erosion and band infection. Operation costs were about $2000 lower with this method than with standard gastric bypass surgery. Postop the patients lost weight by 3–4 kg per month.

Conclusion

Preliminary results show that laparoscopic band-separated one anastomosis gastric bypass have feasibility, safety, efficacy, and reduced operating costs.

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Authors and Affiliations

  1. Department of Endosurgery, Astana Medical University, Astana, Kazakhstan

    Oral B. Ospanov

  2. Society of Bariatric and Metabolic Surgery of Kazakhstan, Astana, Kazakhstan

    Oral B. Ospanov

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  1. Oral B. Ospanov
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Correspondence to Oral B. Ospanov.

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Conflict of Interest

The author declares that they have no conflict of interest.

Ethical and Governance Approvals

All necessary ethical and governance approvals were obtained from the Ethics Committee of Astana Medical University (No. 7. 17.07.2015).

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

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

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Ospanov, O.B. Laparoscopic Band-Separated One Anastomosis Gastric Bypass. OBES SURG 26, 2268–2269 (2016). https://doi.org/10.1007/s11695-016-2281-2

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  • DOI: https://doi.org/10.1007/s11695-016-2281-2

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