apc a-00033-consensus conference

a-00033

Dr. Robert RUTLEDGETitle of Paper: FIRST INTERNATIONAL CONSENSUS

CONFERENCE ON MINI-GASTRIC BYPASS / ONE ANASTOMOSIS BYPASS PARIS 2012; TECHNICAL

PERFORMANCENationality: United States of America

Position: DirectorDepartment: Surgery

Organization: Center For Laparoscopic Obesity SurgeryTel: +1-702 714 0011E-mail: drr@clos.net

FIRST INTERNATIONAL CONSENSUS CONFERENCE

MINI-GASTRIC BYPASS / ONE ANASTOMOSIS BYPASS

PARIS 2012

Robert RUTLEDGE11Director, Surgery, Center For Laparoscopic Obesity Surgery, United States of America

FIRST INTERNATIONAL CONSENSUS CONFERENCE

MINI-GASTRIC BYPASS / ONE ANASTOMOSIS BYPASS

PARIS 2012

Introduction

• The Mini-Gastric Bypass / One Anastomosis Bypass (MGB) is gaining international recognition.

Introduction

• In October 2012 • 50 surgeons from around the world met in

Paris for the • First International Consensus Conference

on the MGB/OAB. • Producing a consensus document on• Results and • Important technical performance issues

Purpose

• The purpose of this paper is to report on the results of the survey and discussions on the technical issues in performance of the MGB.

Methods:

• In Addition to Consensus Conference

• Surgeons were canvassed from around the world.

Results

• Replies were obtained from • 29 countries, • 6 continents, • 49 surgeons attended the Paris

conference and • 112 surgeons completed survey.

49 Surgeons from 29 Countries

Results

• Two methods of performing the MGB/OAB,

• One Anastomosis Gastric Bypass Anti-reflux Technique of Garcia-Caballero / Carbajo (OAGB) or the

• “Mini-Gastric Bypass” technique

Surgical Technique

• 27% used the OAGB technique and

• 68% used the “MGB technique of Rutledge.“

• Other Modified Rutledge/OA techniques

Results

• Intraoperative methylene blue test performed in 86.4%,

• intraoperative "Air Inflation" test used always by 29.2%,

• Postoperative NG tube 20.8%,

Results

• Post Op Drains; • 2 drains, Always 12.5%, • 1 drain, Always 54.2%.

• Postop UGI: • Always 33.3%; • Almost Never 25%; • Never 25%

Results

• Average # of MGB/OAB surgeon’s cases last year 221+41,

• Average age 41+9, mean BMI 46+5, • Average bougie size 35f+3, • # ports used 5, • Mean length of pouch (cm) 19+4, • Length of bypass (cm) 197+20, • Op time (minutes) 73+15, • Blood loss (ml) 51+11, • Hospital stay (d) 3.4+4.

Results

• Results reported to be excellent: • Resolution of Diabetes 79%, • Excess weight loss 76%,

(Three reported 100% +/- EWL)• Weight Loss "Failure" 3% and • 81% Lost More than 50% of EW.

Conclusions:

• The MGB/OAB is gaining worldwide use and recognition.

• The First International Consensus Conference on MGB / OAB demonstrated

• Key technical performance issues and

• Confirmed excellent outcomes in many surgeons around the world.