Background:
OAGB is a safe and effective primary and revision bariatric procedure. The safety of the addition of a MMR to improve durability of weight loss is unreported following OAGB.
Objectives:
To review early results of the safety of insertion of a MMR during primary and revision OAGB.
Methods:
Retrospective analysis of our prospective database from March 2015 to June 2017. Revision OAGB was performed as a single stage procedure (in all but 1 patient) following a non-responding first restrictive procedure; including gastric band or sleeve gastrectomy. We assessed early (within 30 days) and late morbidity and mortality.
Results:
We identified 137 patients who underwent OAGB. Eighteen patients had OAGB + MMR: primary OAGB + MMR (n = 5; mean age 41 years, 4 female, 1 male, mean BMI 51.4 kg/m2), single-stage revision surgery to OAGB + MMR (n = 12; previous gastric band = 5; previous sleeve gastrectomy= 7; mean age 44 years, all female, mean BMI 44.3 kg/m2) and 2-stage revision surgery from band to OAGB + MMR (n = 1; age 38 years, female, BMI 57 kg/m2). One patient re-presented following primary OAGB + MMR with dysphagia and functional hold up at the MMR. Three patients re-presented following revision OAGB + MMR; intractable bile acid reflux requiring conversion to RNYGP (n = 1); small bowel obstruction with port site hernia (n = 1) and dysphagia secondary to stenosis at the gastro-enterostomy (n = 1). There were no deaths. No patients required removal of MMR following a median follow up period of 6 months.
Conclusion:
Our early results suggest MMR can safely be inserted at the time of primary or single-stage revision OAGB.