title: Understanding Objections to One Anastomosis (Mini) Gastric Bypass: A Survey of 417 Surgeons Not Performing this Procedure.
abstract: Despite published experience with thousands of patients, the uptake of One Anastomosis/Mini Gastric Bypass (OAGB/MGB) has been less than enthusiastic and many surgeons still harbour objections to this procedure. The purpose of this study was to understand these objections scientifically.
  
  
  
  Bariatric surgeons from around the world were invited to participate in a questionnaire-based survey on SurveyMonkey®. Surgeons already performing this procedure were excluded.
  
  
  
  Four hundred seventeen bariatric surgeons (from 42 countries) not currently performing OAGB/MGB took the survey. There were 211/414 (50.97%) and 188/414 (45.41%) respondents who expressed concerns that it will lead to an increased risk of gastric and oesophageal cancers respectively. A total of 62/416 (14.9%) and 201/413 (n = 48.6%) surgeons respectively felt that OAGB/MGB was associated with a higher early (30-day) and late complication rate compared to the RYGB. Moreover, 7.8% (n = 32/411) and 16.26% (n = 67/412) of the respondents were concerned that OAGB/MGB carried a higher early (30-day) and late mortality, respectively, in comparison with the RYGB. There were 79/410 (19.27%) and 88/413 (21.3%) respondents who were concerned that OAGB/MGB was not an effective procedure for weight loss and co-morbidity resolution, respectively. A total of 258/411 (62.77%) respondents reported that OAGB/MGB was not approved by their national society as a mainstream bariatric procedure; 51.0% of these surgeons would start performing this procedure if it was.
  
  
  
  Surgeons not performing OAGB/MGB cite a number of concerns for not performing this operation. This survey is the first scientific attempt to understand these objections scientifically.
authors.affiliation: Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK. kamal_mahawar@hotmail.com.
authors.forename: Kamal K
authors.initials: KK
authors.lastname: Mahawar
authors.affiliation: University Hospital Lewisham, Lewisham and Greenwich NHS Trust, London, UK.
authors.forename: Cynthia-Michelle
authors.initials: CM
authors.lastname: Borg
authors.affiliation: Kular Hospital, Bija, Punjab, India.
authors.forename: Kuldeepak Singh
authors.initials: KS
authors.lastname: Kular
authors.affiliation: Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: Michael J
authors.initials: MJ
authors.lastname: Courtney
authors.affiliation: Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: Karim
authors.initials: K
authors.lastname: Sillah
authors.affiliation: Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: William R J
authors.initials: WRJ
authors.lastname: Carr
authors.affiliation: Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: Neil
authors.initials: N
authors.lastname: Jennings
authors.affiliation: Royal Derby Hospital, Derby, UK.
authors.forename: Brijesh
authors.initials: B
authors.lastname: Madhok
authors.affiliation: Birmingham Heartlands Hospital, Birmingham, UK.
authors.forename: Rishi
authors.initials: R
authors.lastname: Singhal
authors.affiliation: Bariatric Unit, Sunderland Royal Hospital, Sunderland, SR4 7TP, UK.
authors.forename: Peter K
authors.initials: PK
authors.lastname: Small
mesh_terms: D000328:Adult; D001291:Attitude of Health Personnel; D015897:Comorbidity; D032882:Comprehension; D005260:Female; D015390:Gastric Bypass / Q000009:adverse effects / Q000523:psychology* / Q000706:statistics & numerical data*; D006801:Humans; D008297:Male; D009767:Obesity, Morbid / Q000453:epidemiology / Q000601:surgery*; D011183:Postoperative Complications / Q000453:epidemiology / Q000517:prevention & control / Q000523:psychology; D016079:Refusal to Treat / Q000706:statistics & numerical data*; D066231:Surgeons / Q000523:psychology* / Q000706:statistics & numerical data*; D011795:Surveys and Questionnaires; D015431:Weight Loss
keywords: Bile reflux; Gastric cancer; Malnutrition; Mini gastric bypass; Objections; Oesophageal cancer; Omega loop gastric bypass; One anastomosis gastric bypass; Single anastomosis gastric bypass