Mini Gastric Bypass (OAGB)
Single Anastomosis Gastric Bypass (OAGB)
What is a Mini Gastric Bypass?
The mini gastric bypass is a restrictive procedure with a significant malabsorptive component. It involves reducing food intake while also limiting the absorption of ingested food, leading to weight loss. Although there is limited data on the hormonal effects after a single anastomosis gastric bypass (OAGB), it is known to promote early satiety and reduce appetite.
How Does It Work?
The mini gastric bypass involves two surgical stages:
- Restrictive Stage: A small, vertical gastric pouch is created, holding about 60 ml of food. This pouch is disconnected from the rest of the stomach, which remains intact but no longer receives food.
- Anastomosis Stage: The small gastric pouch is connected directly to the small intestine, bypassing 200-250 cm of the intestine from the duodenum. Unlike the standard gastric bypass, this procedure can be fully reversed if necessary, restoring the original anatomy.
Key Differences from Standard Gastric Bypass:
- A longer gastric reservoir is created.
- There is a single anastomosis between the stomach and intestine.
As with the standard bypass, the stomach and duodenum are entirely excluded from the digestive process, meaning that traditional diagnostic methods cannot explore these areas after surgery. The procedure reduces body weight by both limiting the volume of food ingested and triggering early satiety through the direct delivery of food to a segment of the small intestine unaccustomed to undigested food.
What Are the Potential Complications?
Over time, some complications may arise, including:
- Nutrient Deficiencies: Deficiency in iron, vitamin B12, or folic acid can occur due to bypassing most of the stomach and the entire duodenum. This can be managed with supplements (oral, intramuscular, or intravenous).
- Osteoporosis: Calcium deficiency is common due to the lack of food passage through the duodenum, a key site for calcium absorption. Oral calcium supplements are often required.
- Anastomotic Ulcer: Ulcers at the junction of the stomach and intestine are rare but more likely in smokers and alcohol consumers. This condition can typically be treated with medication, though surgery may be needed in rare cases.
Who Can Benefit from a Mini Gastric Bypass?
Single anastomosis gastric bypass is particularly recommended for individuals with a BMI over 50 (severely obese) who do not suffer from gastroesophageal reflux disease (GERD). It is an effective option for those seeking substantial weight loss and metabolic improvements.
Follow-Up Visits
Regular follow-up is crucial to optimize weight loss and manage potential issues like nutrient deficiencies and gastroesophageal reflux. These appointments help ensure long-term success and health maintenance.
Preparation Requirements
Before surgery, patients must undergo an esophagogastroduodenoscopy to check for reflux esophagitis and other conditions affecting the stomach or duodenum. This step ensures the procedure is safe and appropriate.
Bariatric and Metabolic Surgery
Surgical treatment of patients with morbid obesity
Sleeve gastrectomy
