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

Obes Surg. 2017 Sep;27(9):2222-2228. doi: 10.1007/s11695-017-2663-0.

Abstract

Background: 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.

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

Results: 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.

Conclusions: 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.

Keywords: Bile reflux; Gastric cancer; Malnutrition; Mini gastric bypass; Objections; Oesophageal cancer; Omega loop gastric bypass; One anastomosis gastric bypass; Single anastomosis gastric bypass.

MeSH terms

  • Adult
  • Attitude of Health Personnel
  • Comorbidity
  • Comprehension
  • Female
  • Gastric Bypass / adverse effects
  • Gastric Bypass / psychology*
  • Gastric Bypass / statistics & numerical data*
  • Humans
  • Male
  • Obesity, Morbid / epidemiology
  • Obesity, Morbid / surgery*
  • Postoperative Complications / epidemiology
  • Postoperative Complications / prevention & control
  • Postoperative Complications / psychology
  • Refusal to Treat / statistics & numerical data*
  • Surgeons / psychology*
  • Surgeons / statistics & numerical data*
  • Surveys and Questionnaires
  • Weight Loss