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Kermansaravi M, Shahmiri SS, Kow L, Gawdat K, Abbas SI, Aly A, Bashir A, Bhandari M, Haddad A, ElFawal MH, Inam A, Kasama K, Kim SH, Kular KS, Lakdawala M, Layani LA, Lee WJ, Pazouki A, Prasad A, Safadi B, Wang C, Yang W, Adib R, Jazi AHD, Shabbir A. Technical Variations and Considerations around OAGB in IFSO-APC and IFSO-MENAC Chapters, an Expert Survey. Obes Surg 2024; 34:2054-2065. [PMID: 38662251 DOI: 10.1007/s11695-024-07239-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/11/2024] [Accepted: 04/16/2024] [Indexed: 04/26/2024]
Abstract
OBJECTIVE This study aimed to evaluate the technical variations of one-anastomosis gastric bypass (OAGB) among IFSO-APC and MENAC experts. BACKGROUND The multitude of technical variations and patient selection challenges among metabolic and bariatric surgeons worldwide necessitates a heightened awareness of these issues. Understanding different perspectives and viewpoints can empower surgeons performing OAGB to adapt their techniques, leading to improved outcomes and reduced complications. METHODS The scientific team of IFSO-APC, consisting of skilled bariatric and metabolic surgeons specializing in OAGB, conducted a confidential online survey. The survey aimed to assess technical variations and considerations related to OAGB within the IFSO-APC and IFSO-MENAC chapters. A total of 85 OAGB experts participated in the survey, providing their responses through a 35-question online format. The survey took place from January 1, 2024, to February 15, 2024. RESULTS Most experts do not perform OAGB for children and adolescents younger than 18 years. Most experts create the gastric pouch over a 36-40-F bougie and prefer to create a gastrojejunostomy, at the posterior wall of the gastric pouch. An anti-reflux suture during OAGB is performed in all patients by 51.8% of experts. Most experts set a common limb length of > 4 m in revisional and conversional OAGBs to prevent nutritional complications. CONCLUSION The ongoing debate among metabolic and bariatric surgeons regarding the technical variations and patient selection in OAGB remains a significant point of discussion. This survey demonstrated the variations in technical aspects and patient selection for OAGB among MBS surgeons in the IFSO-APC and IFSO-MENAC chapters. Standardizing the OAGB technique is crucial to ensure optimal safety and efficacy in this procedure.
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Affiliation(s)
- Mohammad Kermansaravi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Shahab Shahabi Shahmiri
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | - Lilian Kow
- Adelaide Bariatric Centre, Flinders University of South Australia, Adelaide, Australia
| | - Khaled Gawdat
- Bariatric Surgery Unit, Faculty of Medicine, Ain Shams University, Cairo, Egypt
| | | | - Ahmad Aly
- Austin and Repatriation Medical Centre, Heidelberg, Victoria, Australia
- University of Melbourne, Melbourne, Australia
| | - Ahmad Bashir
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC), Jordan Hospital, Amman, Jordan
| | | | - Ashraf Haddad
- Minimally Invasive and Bariatric Surgery, Gastrointestinal Bariatric and Metabolic Center (GBMC), Jordan Hospital, Amman, Jordan
| | | | - Atif Inam
- Metabolic, Thoracic & General Surgery Unit III, Department of General Surgery, Pakistan Institute of Medical Sciences, Islamabad, Pakistan
| | - Kazunori Kasama
- Weight Loss and Metabolic Surgery Center, Yotsuya Medical Cube, Tokyo, Japan
| | - Sang Hyun Kim
- Department of Surgery, Soonchunhyang University Seoul Hospital, Seoul, Republic of Korea
| | | | | | | | - Wei-Jei Lee
- Medical Weight Loss Center, China Medical University Hsinchu Hospital, Zhubei, Taiwan
| | - Abdolreza Pazouki
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran
| | | | | | - Cunchuan Wang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Wah Yang
- Department of Metabolic and Bariatric Surgery, The First Affiliated Hospital of Jinan University, Guangzhou, China
| | - Reza Adib
- The Wesley Hospital, Auchenflower, Queensland, Australia
| | - Amir Hossein Davarpanah Jazi
- Department of Surgery, Minimally Invasive Surgery Research Center, Division of Minimally Invasive and Bariatric Surgery, Hazrat‑E Fatemeh Hospital, School of Medicine, Iran University of Medical Sciences, Tehran, Iran.
| | - Asim Shabbir
- National University of Singapore, Singapore, Singapore
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Areas of Non-Consensus Around One Anastomosis/Mini Gastric Bypass (OAGB/MGB): A Narrative Review. Obes Surg 2021; 31:2453-2463. [PMID: 33598845 DOI: 10.1007/s11695-021-05276-2] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/08/2020] [Revised: 02/02/2021] [Accepted: 02/08/2021] [Indexed: 12/11/2022]
Abstract
PURPOSE One anastomosis/mini gastric bypass (OAGB/MGB) is now an established bariatric and metabolic surgical procedure with good outcomes. Despite two recent consensus statements around OAGB/MGB, there are some issues which are not accepted as consensus and need more long-term data and research. MATERIAL AND METHODS After identifying the topic of non-consensus from the two recent OAGB/MGB consensuses, PubMed, Scopus, and Cochrane were searched for articles published by November 2020. RESULTS In this study, we evaluated these non-consensus topics around OAGB/MGB and all related articles on these topics were assessed by authors to have an argument on these items. CONCLUSION There is enough evidence to include OAGB/MGB as an accepted standard bariatric and metabolic surgical procedure. However, long-term data and more research are needed to have a consensus in all aspects including these non-consensus topics.
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Paul L, van der Heiden C, van Hoeken D, Deen M, Vlijm A, Klaassen RA, Biter LU, Hoek HW. Cognitive Behavioral Therapy Versus Usual Care Before Bariatric Surgery: One-Year Follow-Up Results of a Randomized Controlled Trial. Obes Surg 2020; 31:970-979. [PMID: 33170444 PMCID: PMC7921027 DOI: 10.1007/s11695-020-05081-3] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2019] [Revised: 10/15/2020] [Accepted: 10/21/2020] [Indexed: 12/11/2022]
Abstract
BACKGROUND Although early results of bariatric surgery are beneficial for most patients, some patients regain weight later. Cognitive behavioral therapy (CBT) has been suggested as a way to improve patients' psychological health and maintaining weight loss in the longer term. The added value of preoperative CBT to bariatric surgery was examined. Pre- and posttreatment and 1-year follow-up data are presented. METHODS In a multi-center randomized controlled trial, CBT was compared to a treatment-as-usual (TAU) control group. Measurements were conducted pre- and posttreatment/pre-surgery (T0 and T1) and at 1-year post-surgery (T2). Patients in the intervention group received 10 individual, weekly sessions of preoperative CBT focused on modifying thoughts and behaviors regarding eating behavior, physical exercise, and postoperative life style. Outcome measures included weight change, eating behavior, eating disorders, depression, quality of life, and overall psychological health. RESULTS Though no significant differences between conditions were found per time point, in the CBT, condition scores on external eating, emotional eating, depressive symptoms, and psychological distress decreased significantly more over time between pre- (T0) and posttreatment (T1) pre-surgery compared to TAU. No significant time x condition differences were found at 1-year post-surgery (T2). CONCLUSIONS Compared to TAU, preoperative CBT showed beneficial effects on eating behavior and psychological symptoms only from pretreatment to posttreatment/pre-surgery, but not from pre-surgery to 1-year post-surgery. Preoperative CBT does not seem to contribute to better long-term outcomes post-surgery. Recent studies suggest that the optimal time to initiate psychological treatment may be early in the postoperative period, before significant weight regain has occurred. TRIAL REGISTRATION https://www.trialregister.nl Identifier: Trial NL3960.
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Affiliation(s)
- Linda Paul
- PsyQ Department of Eating Disorders, Rotterdam, Netherlands.,Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH, The Hague, Netherlands
| | - Colin van der Heiden
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH, The Hague, Netherlands.,Institute of Psychology, Erasmus University, Rotterdam, Netherlands
| | - Daphne van Hoeken
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH, The Hague, Netherlands
| | - Mathijs Deen
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH, The Hague, Netherlands.,Institute of Psychology, Leiden University, Leiden, Netherlands
| | - Ashley Vlijm
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH, The Hague, Netherlands
| | - René A Klaassen
- Department of Surgery, Maasstad Hospital, Rotterdam, Netherlands
| | - L Ulas Biter
- Department of Surgery, Franciscus Gasthuis & Vlietland, Rotterdam, Netherlands
| | - Hans W Hoek
- Parnassia Psychiatric Institute, Kiwistraat 43, 2552 DH, The Hague, Netherlands. .,Department of Psychiatry, University of Groningen, University Medical Center Groningen, Groningen, Netherlands. .,Department of Epidemiology, Mailman School of Public Health, Columbia University, New York, NY, USA.
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