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Abstract

Objectives: To assess the outcomes of Single anastomosis Gastric Bypass in the management of Morbid Obesity.Materials and Methods: This study was conducted at Lady Reading Hospital, Peshawar between 1st June, 2017 and 28th February 2021 and included 88 patients that underwent Mini-gastric Bypass/ One anastomosis gastric bypass. Following DVT prophylaxis with subcutaneous enoxaparin, a 15-18 cm long gastric pouch was formed over a bougie 36-40Fr and a variable length of biliopancreatic limb was decided between 150-200cm, which was anastomosed to the terminal part of the gastric pouch. All anastomoses were Antecolic fashioned and a minimum 3cm anastomosis preferably to the anterior wall was performed. In all cases Covidien ENDO GIA TristapleTM technology reloads were used and enterotomies were closed using Barbed V-lockR 2/0 sutures. During follow-up relevant investigations based of emerging complaints and monitoring of weight was performed and documented on an approved proforma.Results: Out of totla 88 patients, the mean age of patients was 38.7 years (+12.3) with predominantly male patients (53.4%). Mean Body Mass Index was 55.1(+7.8) with a mean operative time of 127.6(+37.1) min. Remission of diabetes, hypertension and improvement in patients with obstructive sleep apnea at end of 6 months was observed in 37 patients (66%), 41patients (80.3%) and 25 patients (89.2%) respectively. Excess body weight loss at one month was 26.5% and at six months was 58.1%. There were no leaks observed in this study and two cases had bleeds (2.2%). One mortality (1.1%) was observed due to pulmonary embolism. Conclusion: One Anastomosis Gastric Bypass is a safe and eff ective procedure which can be modified and tailored to the individual needs of most bariatric patients including Super Obese patients. It has good results in maintaining remission of Diabetes and Hypertension.