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.
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Abbreviations
- OAGB/MGB:
-
One Anastomosis (Mini) Gastric Bypass
- IFSO:
-
International Federation for the Surgery of Obesity and Metabolic Disorders
- RYGB:
-
Roux-en-Y Gastric Bypass
- GERD:
-
Gastro-Esophageal Reflux Disease
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KM conceived the idea for this exercise, moderated it, analysed the results, and wrote large sections of the manuscript. All other authors helped with determining the methodology of the exercise, provided feedback at every stage, took part in the voting, critically reviewed the manuscript, and provided leadership. All authors have seen the final draft and approve of it.
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The authors declare that they have no conflict of interest. Jacques Himpens is a consultant with Medtronic and with Ethicon.
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Mahawar, K.K., Himpens, J., Shikora, S.A. et al. The First Consensus Statement on One Anastomosis/Mini Gastric Bypass (OAGB/MGB) Using a Modified Delphi Approach. OBES SURG 28, 303–312 (2018). https://doi.org/10.1007/s11695-017-3070-2
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DOI: https://doi.org/10.1007/s11695-017-3070-2