Kamal K Mahawar1, Jacques Himpens2, Scott A Shikora3, Jean-Marc Chevallier4, Mufazzal Lakdawala5, Maurizio De Luca6, Rudolf Weiner7, Ali Khammas8, Kuldeepak Singh Kular9, Mario Musella10, Gerhard Prager11, Mohammad Khalid Mirza12, Miguel Carbajo13, Lilian Kow14, Wei-Jei Lee15, Peter K Small16. 1. Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. kamal_mahawar@hotmail.com. 2. St. Pierre University Hospital, Brussels, Belgium. 3. Brigham and Women's Hospital, Harvard Medical School, Boston, MA, USA. 4. Université Paris 5, Paris, France. 5. Digestive Health Institute, Mumbai, India. 6. Montebelluna Treviso Hospital, Treviso, Italy. 7. Clinic Obesity Surgery, Sana-Klinikum Offenbach, Offenbach, Germany. 8. Rashid Hospital, Dubai, United Arab Emirates. 9. Kular College and Hospitals Pvt. Ltd., Bija, Ludhiana, Punjab, India. 10. Advanced Biomedical Sciences Department, Federico II University, Naples, Italy. 11. Medical University of Vienna, Vienna, Austria. 12. King Fahad University Hospital, Khobar, Saudi Arabia. 13. Centre of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain. 14. Adelaide Bariatric Centre, Adelaide, Australia. 15. Min-Sheng General Hospital, Taoyuan City, Taiwan. 16. Bariatric Unit, Department of General Surgery, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
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.
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.
Entities:
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
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