Abdelrahman A. Nimeri, President of the IFSO Middle-East North Africa Chapter, from Abu Dhabi, explains the surgical and nutritional complications of One Anastomosis Gastric Bypass, also known as Mini Gastric Bypass.
OAGB/MGB is a new procedure that is still uncommon but is becoming increasingly popular. In 2014 its prevalence was less than 2% of all bariatric and metabolic procedures, with the largest prevalence in the Asia Pacific and Middle-East North Africa regions. This technique was first described in 2001 and in April 2016 there were around 500 publications concerning this technique.
Dr. Nimeri reviews the published literature on OAGB/MGB with the possible surgical complications during the learning curve. He underlines the importance of making a long pouch to avoid bile reflux gastritis and measuring all the small bowel length to avoid nutritional deficiencies.
He explains that OAGB/MGB is more effective than RYGB for weight loss and comorbidity resolution because of an increased malabsorption. On the other hand, this technique is associated with a learning curve and with nutritional deficiencies that are not uncommon if the entire small bowel length is not measured. Finally, in a patient with recurrent pain after OAGB/MGB and with normal studies, an internal hernia should be suspected until proven otherwise.
When a leak occurs after OAGB/MGB, most of the time it is in the gastrojejunostomy and a conversion to RYGB may be necessary.