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

Obes Surg. 2018 Feb;28(2):303-312. doi: 10.1007/s11695-017-3070-2.

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.

Keywords: Consensus statement; Delphi approach; Gastric bypass; Loop gastric bypass; Mini gastric bypass; Omega loop gastric bypass; One anastomosis gastric bypass; Single anastomosis gastric bypass.

Publication types

  • Consensus Development Conference

MeSH terms

  • Bariatric Surgery / methods
  • Bariatric Surgery / standards
  • Consensus
  • Delphi Technique
  • Gastric Bypass / methods*
  • Gastric Bypass / standards*
  • Geography
  • Humans
  • Internationality
  • Obesity, Morbid / surgery*
  • Stomach / surgery