SAGB (Single Anastomoses Gastric Bypass)

[southernlady]

Being discussed at ASMBS.

It does have a the advantage of keeping the the pyloric valve, avoiding bile reflux. Who know how it will be received but it’s probably gonna be another one confused as a DS.

 

[hilary1617]

Interesting. I'm all in favor of pyloric valve preservation. What's the point in keeping the rest of the stomach around though? Thanks for sharing.

 

[southernlady]

Interesting. I'm all in favor of pyloric valve preservation. What's the point in keeping the rest of the stomach around though? Thanks for sharing.

Absolutely no clue. Cindy Kay over on FB is the one attending ASMBS. When she is done, I’ll see if she has more info on that one.

 

[Georgepds]

Interesting. I'm all in favor of pyloric valve preservation. What's the point in keeping the rest of the stomach around though? Thanks for sharing.

I know they always do this with classic GB

Possible reasons: stomach secretions, retain possibility if reversal.. but I'm just guessing

From pub med

The Gastric Remnant in Roux-en-Y Gastric Bypass: Challenges and Possibilities - PubMed

Laparoscopic Roux-en-Y gastric bypass (RYGB) is widely applied in the treatment of morbid obesity. Health personnel meeting these patients should thus be familiar with the potential clinical consequences of the modified anatomy induced by the surgery. After a RYGB, the stomach is left in situ...

pubmed.ncbi.nlm.nih.gov

What happens to the remnant stomach after gastric bypass?

"After a RYGB, the stomach is left in situ after the closure of the upper part of the organ. This blind-ended gastric remnant may cause complications and surgical emergencies, but also opportunities for diagnostic and therapeutic intervention.


"Opportunities offered by the remnant, including minimal invasive or open access for enteral nutrition, and therapeutic and diagnostic access to the bile ducts, the duodenum, and the gastric remnant, which is challenged by the modified anatomy, are discussed. Reversal of the gastric bypass and gastrointestinal reconstruction after esophageal resection have been commented on.

 

[hilary1617]

I know they always do this with classic GB

Possible reasons: stomach secretions, retain possibility if reversal.. but I'm just guessing

I understand why they do it for classic GB, as they are making a tiny pouch and bypassing the pyloric valve. If they are creating a sleeve and preserving pyloric valve function, it doesn't make sense to me at all to retain the discarded remnant...

 

[Georgepds]

Is the the remnant somach attached to the intestine leading to the new point at which the pyloric valve meets the intestine?

This part of the intestine, which now carries no food, is the bile path. Perhaps there are other secretions of the remnant stomach which are potentially beneficial.

Or, it could be just simpler to leave it there. The stomach remnant is vascularized, and, if you remove it, you have to tie off all those conduits. This takes time, and duration of surgery is best minimized. That said, I suppose you still have to staple the remnant, and that too takes time

Just guessing, I have no idea of the reason