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Essentials of Mini ‒ One Anastomosis Gastric Bypass pp 215–243Cite as

Anti-Reflux One-Anastomosis Gastric Bypass (OAGB)—(Spanish BAGUA): Step-By-Step Technique, Rationale and Bowel Lengths

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Abstract

The One-Anastomosis Gastric Bypass (OAGB) is a technical modification of the Mini-Gastric Bypass (MGB) which was developed in the year 2002. Although both procedures have the common principles of performing only one anastomosis and avoiding an alimentary (Roux) limb, OAGB includes some different technical and conceptual proposals which among others, essentially include: (1) Complete measurement of the entire small bowel (SB) to determine extent of bypassed biliopancreatic limb and common channel; lengths of these segments are not fixed but assigned according to body mass index, SB length and other metabolic variables, which lead OAGB into having a more malabsorptive profile, (2) Explicit dissection of the angle of His and a very long and narrow gastric pouch constructed over a 36-Fr calibration tube, (3) Creation of an “anti-reflux mechanism” by an 8–10 cm latero-lateral continuous suture between the (selected) SB and gastric pouch, which is reinforced by fixation of the apex of the SB to the excluded stomach, (4) Width of the latero-lateral gastro-ileal anastomosis (~2.5 cm) is wider than in Roux-Y Gastric Bypass, but not as wide as in MGB. Implementation of all these measures has turned OAGB into a more robust operation which minimizes the possibility of reflux or marginal ulcer and leads to better medium- and long-term results in terms of weight loss and metabolic benefits.

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Abbreviations

BMI:

Body mass index

BP:

Biliopancreatic

CCh:

Common Channel

EGJ:

Esophago-gastric junction

FU:

Follow-up

GERD:

Gastroesophageal reflux disease

MGB:

Mini-gastric bypass

OAGB:

One-anastomosis gastric bypass

RLQ:

Right Lower Quadrant

RYGB:

Roux-en-Y gastric bypass

SB:

Small bowel

ST:

Surgical Table

WL:

Weight loss

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Author information

Authors and Affiliations

  1. Center of Excellence for the Study and Treatment of Obesity and Diabetes, Valladolid, Spain

    Miguel A. Carbajo MD, PhD, Enrique Luque-de-León MD & Jaime Ruiz-Tovar MD, PhD

  2. Center of Excellence for the Study and Treatment of Obesity and Diabetes—Latinamerican Affiliated Subsidiary/The American British Cowdray Medical Center, I.A.P./Hospital de Especialidades, Centro Médico Nacional (IMSS), México City, Mexico

    Enrique Luque-de-León MD

  3. General and Bariatric Surgeon, Cancún, Mexico

    Juan F. Valdez-Hashimoto MD

  4. Universidad Autónoma de Madrid, Madrid, Spain

    Jaime Ruiz-Tovar MD, PhD

Authors
  1. Miguel A. Carbajo MD, PhD
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  2. Enrique Luque-de-León MD
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  3. Juan F. Valdez-Hashimoto MD
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  4. Jaime Ruiz-Tovar MD, PhD
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Editor information

Editors and Affiliations

  1. Obesity Surgery, Toronto, Ontario, Canada

    Mervyn Deitel

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Carbajo, M.A., Luque-de-León, E., Valdez-Hashimoto, J.F., Ruiz-Tovar, J. (2018). Anti-Reflux One-Anastomosis Gastric Bypass (OAGB)—(Spanish BAGUA): Step-By-Step Technique, Rationale and Bowel Lengths. In: Deitel, M. (eds) Essentials of Mini ‒ One Anastomosis Gastric Bypass. Springer, Cham. https://doi.org/10.1007/978-3-319-76177-0_24

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  • DOI: https://doi.org/10.1007/978-3-319-76177-0_24

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  • Publisher Name: Springer, Cham

  • Print ISBN: 978-3-319-76176-3

  • Online ISBN: 978-3-319-76177-0

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