Omega-loop Bypass Research Articles

How I do it Afferent loop obstruction (ALO) with hyper-amylasemia and deranged liver function test , are we going to see this complication more frequently again? Emergency conversion of One anastomosis gastric bypass (OAGB) to a Roux-en-Y Gastric bypass (

Abstract
 Afferent loop syndrome is a known complication of gastric surgery specifically after Billroth II and to a lesser extent a Roux –en-Y reconstruction. However the incidence decreased over the years proportionally with the decrease in the number of gastric surgery.
 Afferent loop syndrome can be either acute or chronic with different presentation and treatment options. The acute type can occur early post operatively or it could be delayed presentation. Acute ALS is associated with complete closed loop obstruction and considered a surgical emergency, whereas chronic ALS is mostly related to partial obstruction of the afferent loop.
 This rare complication can occur after the single anastomosis gastric bypass (Omega loop bypass) as it is a type of Billroth II reconstruction of gastric pouch –jejunostomy.
 With the increase in the number of SAGB performed all over the world as weight reduction surgery for morbidly obese patient s surgeons should be aware of this complication and the treatment options. 

A498 Calibrated Gastro-Jejunostomy Reduces the Incidence of Stenosis in Omega Loop Bypass

The numbers of Omega Loop Gastric Bypass have increased dramatically in the middle east area in the last 15 years. It has been demonstrated that it is a rapid, safe and effective bariatric operation. Advantages include; lower risk of anastomotic leakage, internal herniation and the ease of reversibility. Potential complications include; marginal ulcers, chronic alkaline reflux and gastro-jejunostomy (GJ) stenosis. This retrospective analysis evaluates whether suturing the gastro-jejunostomy (GJ) over a boogie effects the rate of GJ stenosis and the need for endoscopic balloon dilatation or refashioning later on. Retrospective analysis to assess the effectiveness of anastomosing the GJ on a calibration tube in reducing GJ stenosis after omega loop surgery.

A504 Feasibility, Safety and Operative Outcomes of Omega Loop Bypass Reversal

A504 Feasibility, Safety and Operative Outcomes of Omega Loop Bypass Reversal

A535 Hiatal Hernia Repair and Conversion to Omega Loop Bypass after Sleeve Gastrectomy

Sleeve Gastrectomy alters the normal stomach anatomy resulting in a significant incidence of hiatal hernia and gastroesophageal reflux disease. Although many patients remain asymptomatic, many complain of severe reflux symptoms not responsive to medical management. To describe the diagnosis and treatment of hiatus hernia after sleeve gastrectomy with conversion to Omega Loop Bypass and using fixation suture technique.

A537 Single Port Omega Loop Bypass – Safety and Efficacy Introduction

A537 Single Port Omega Loop Bypass – Safety and Efficacy Introduction

A505 Hiatal Hernia Repair and Conversion to Omega Loop Bypass after Gastric Band Removal

A505 Hiatal Hernia Repair and Conversion to Omega Loop Bypass after Gastric Band Removal

A497 Reduced Trocars Omega Loop Bypass - Practical Aspects

A497 Reduced Trocars Omega Loop Bypass - Practical Aspects

The Mini-Gastric Bypass original technique

IntroductionMini-Gastric Bypass (MGB) is becoming more and more popular as shown by the numerous articles published over the past 15 years, supporting the operation as a short and simple procedure with excellent outcomes and low complication rates. There is still confusion amongst surgeons on the technique of the operation. The purpose of this paper is to review and describe the technique of MGB by its originators. MethodsWith 20 years of experience of performing the original MGB, the authors present the details of the MGB. ResultsThe MGB consists of a long conduit from below the crow's foot extending up to the left of the angle of His. It is similar to, but importantly, not the same as the pouch of the Sleeve Gastrectomy. MGB has a wide gastro-jejunal anastomosis to an anti-colic loop of jejunum 150–200 cm distal to the ligament of Trietz. The power of MGB comes from the fact that it is both a “Non-Obstructive” restrictive procedure and it also has a significant fatty food intolerance component with minimal malabsorption. ConclusionIn this article we describe the original Rutledge technique of Mini-Gastric Bypass. Notably this is neither a “Single Anastomosis bypass”, nor an “Omega Loop Bypass” and also not the “One Anastomosis Bypass of Carbajo”. It is a particular technique first created by Rutledge in 1997 and associated with low risk and excellent outcomes. The goal of this manuscript is to help avoid complications and problems seen when the operation deviates from some of the basic principles of general surgery used in the original operation.

225 - Gastric Pressure and Esophageal Reflux Exposure Suggest that Omega-Loop Bypass is Different from Billroth II

225 - Gastric Pressure and Esophageal Reflux Exposure Suggest that Omega-Loop Bypass is Different from Billroth II

Effects of omega-loop bypass on esophagogastric junction function

BackgroundAt present, no objective data are available on the effect of omega-loop gastric bypass (OGB) on gastroesophageal junction and reflux. ObjectivesTo evaluate the possible effects of OGB on esophageal motor function and a possible increase in gastroesophageal reflux. SettingUniversity Hospital, Italy; Public Hospital, Italy. MethodsPatients underwent clinical assessment for reflux symptoms, and endoscopy plus high-resolution impedance manometry (HRiM) and 24-hour pH-impedance monitoring (MII-pH) before and 1 year after OGB. A group of obese patients who underwent sleeve gastrectomy (SG) were included as the control population. ResultsFifteen OGB patients were included in the study. After surgery, none of the patients reported de novo heartburn or regurgitation. At endoscopic follow-up 1 year after surgery, esophagitis was absent in all patients and no biliary gastritis or presence of bile was recorded. Manometric features and patterns did not vary significantly after surgery, whereas intragastric pressures (IGP) and gastroesophageal pressure gradient (GEPG) statistically diminished (from a median of 15 to 9.5, P<.01, and from 10.3 to 6.4, P<.01, respectively) after OGB. In contrast, SG induced a significant elevation in both parameters (from a median of 14.8 to 18.8, P<.01, and from 10.1 to 13.1, P<.01, respectively). A dramatic decrease in the number of reflux events (from a median of 41 to 7; P<.01) was observed after OGB, whereas in patients who underwent SG a significant increase in esophageal acid exposure and number of reflux episodes (from a median of 33 to 53; P<.01) was noted. ConclusionsIn contrast to SG, OGB did not compromise the gastroesophageal junction function and did not increase gastroesophageal reflux, which was explained by the lack of increased IGP and in GEPG as assessed by HRiM.

Greater Weight Loss with the Omega Loop Bypass Compared to the Roux-en-Y Gastric Bypass: a Comparative Study

Despite similar initial results on weight loss and metabolic control, with a better feasibility than the Roux-en-Y gastric bypass (RYGBP), the omega loop bypass (OLB) remains controversial. The aim of this study was to compare the short-term outcomes of the laparoscopic OLB versus the RYGBP in terms of weight loss, metabolic control, and safety. Two groups of consecutive patients who underwent laparoscopic gastric bypass surgery were selected: 20 OLB patients and 61 RYGBP patients. Patients were matched for age, gender, and initial body mass index (BMI). Data concerning weight loss, metabolic outcomes, and complications were collected prospectively. Mean duration of the surgical procedure was shorter in the OLB group (105 vs. 152 min in the RYGBP group; p < 0.001). Mean excess BMI loss percent (EBL%) at 6 months and at 1 year was greater in the OLB group (76.3 vs. 60.0%, p = 0.001, and 89.0 vs. 71.0%, p = 0.002, respectively). After adjustment for age, sex, initial BMI, and history of previous bariatric surgery, the OLB procedure was still associated with a significantly greater 1-year EBL%. Diabetes improvement at 6 months was similar between both groups. The early and late complication rates were not statistically different. There were three anastomotic ulcers in the OLB group, in smokers, over 60 years old, who were not taking proton pump inhibitor medication. In this short-term study, we observed a greater weight loss with OLB and similar efficiency on metabolic control compared to RYGBP. Long-term evaluation is necessary to confirm these outcomes.

P26: Complications, revisions and management of the omega loop bypass

P26: Complications, revisions and management of the omega loop bypass