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Laparoscopic one-anastomosis gastric bypass (OAGB) Study

Discussion in 'Experimental Procedures' started by writegirl, May 12, 2017.

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    writegirl

    writegirl Work in Progress

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    DianaCox

    DianaCox Bad Cop

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    I don't understand the drawing of the surgery - it looks like two gastric sleeves?? What's happening just under the esophagus?

    Found the original paper, including drawing: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5403902/ - it's an odd hybrid of a sleevish-type pouch and gastric bypass - has a blind pouch like RNY

    [​IMG]
     
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    Larra

    Larra Well-Known Member

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    Actually, what it looks like to me is that the small intestine is attached directly to the esophagus in a "loop" configuration, with no pouch at all, and the entire stomach becoming a blind stomach. But I also found their illustration confusing. The new illustration Diana provided is more clear and shows a narrow tube of stomach attached to the small intestine, rather than the usual short pouch done with standard RNY gastric bypass.So this seems to be some kind of variation on the MGB (mini gastric bypass), which is nothing more than a gastric bypass with loop rather than RNY.
    MGB has never been accepted as standard of care in the USA, and many insurance policies (and @DianaCox and I have seen many policies) specifically exclude coverage for this operation. It creates a risk for bile reflux that is not present with the standard of care RNY gastric bypass. I don't know if this new variation would cause this problem. I also don't know if my interpretation of their illustration is accurate.
     
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    Munchkin

    Munchkin Full of Fairy Dust

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    Yikes. If that diagram is correct, I could never recommend this to anyone.
     
    Settledownnow likes this.
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    KathrynK

    KathrynK Well-Known Member

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    The quality of life must be awful. As explained by Robert Rutledge, MD, there are several names for the same surgery, all emerge from the mini gastric bypass (MGB). " Carbajo and Caballero modified the MGB adding an “anti-reflux” technique and called their version the “One-Anastomosis Gastric Bypass (OAGB)”. Others have suggested the Omega Loop Gastric Bypass which is a suitable name, but has its own limitations. The long-used names MGB and OAGB thus stand, and the use of Single Anastomosis Gastric Bypass (SAGB) is similar to OAGB and is likely to be confused with the various SADI procedures."

    They have to fix the terminology so patients know what they are getting. It is easy for surgeons to do and quick. but, there are "concerns with regard to symptomatic gastric or oesophageal biliary reflux requiring revisional surgery and long-term risk of gastric and oesophageal cancers."
    As also explained by Robert Rutledge' MD "The MGB is restrictive while not being obstructive. In contrast to the small pouch and small gastrojejunostomy of the RYGB, the tight gastric pouch of the sleeve, and the fixed plastic of the Lap-band, the MGB uses a larger gastric pouch with a wide open gastrojejunostomy to allow rapid emptying into the jejunum. Also, in contrast to the RYGB, the MGB has a significant malabsorptive component. It induces significant fatty food intolerance, an increase in bowel movements, and mild steatorrhea in response to large fatty meals." This is yet another illustration, of SAGB:
    IMG_0051.JPG
     
  6.  
    writegirl

    writegirl Work in Progress

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    The thing looked scary to me and I am by no means any kind of expert in WLS. What concerned me was that this was shared in a WLS group on FB to comments that were all excited about the "new" procedure. It looks to me like what Larra said, a blind dump into the stomach from the esophagus. If that tiny channel is the "new stomach," it terrifying, quite frankly. Thank you all for chiming in on this. Being new, I really wasn't sure what I was seeing, but it looked crazy to my novice eyes.
     
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    Munchkin

    Munchkin Full of Fairy Dust

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    I think people who get this are going to have a terrible quality of life. But I guess time will tell. Sad!

    Something you will see over and over again. There are huge numbers of people, including medical 'professionals' who think we deserve to miserable to lose weight. I have never understood this but it's true.
     

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