National Introduction of One Anastomosis Gastric Bypass in the UK National Bariatric Surgery Registry
Condition: Obesity
Study type: Observational

Summary: 
      This study is investigating a newer surgical procedure called one-anastomosis gastric bypass
      (OAGB) used for treating obesity within the National Health Service (NHS). We want to
      understand how well this surgery works and its effects on patients' health. We'll look at
      data from adults who had this surgery, tracking everything from before the operation to after
      they go home and comparing to other types of operation for weight loss. We'll check for any
      problems during or after surgery, how long they stay in the hospital, and how much weight
      they lose. We're also interested in seeing if other health issues related to obesity get
      better. By doing this, we hope to learn more about how effective and safe this surgery is and
      how it's being used in hospitals across the country
    

Detailed description: 
      Recent reporting from the International Federation for Surgery for Obesity (IFSO) Registry
      report that the three most common metabolic surgery procedures are sleeve gastrectomy (SG),
      Roux-en-y gastric bypass (RYGB) and one-anastomosis gastric bypass (OAGB)[1]. Introduced by
      Rutledge in 1997[2], OAGB is now increasing being used in bariatric practice. Recent network
      meta-analysis indicates OAGB may offer comparable weight loss whilst minimising
      complications[3]. Literature published from both the IFSO Registry and the Israeli National
      Registry indicate increased use of OAGB in the surgical treatment of obesity[1, 4].

      The safe introduction of new surgical procedures can be confounded by learning effects for
      both operative technique and perioperative care practices[5]. No study has yet considered the
      introduction of OAGB at a population or national registry level.

      The aim of the study is to study the introduction of OAGB into NHS practice in the national
      bariatric surgery registry.

      Study population: Adult patients undergoing surgery for obesity using one-anastomosis gastric
      bypass Exclusions: Paediatric cases

      Data All patient undergoing OAGB operations within the NBSR - pre-operative, intra-operative
      and postoperative data as described below

      Outcome measures Perioperative outcomes Complications Return to theatre Length of stay
      Percentage of OAGB practice as a proportion of total bariatric surgery practice at individual
      hospitals

      Longer term outcomes Total body weight loss Excess weight loss Remission of comorbidities

      References

        1. Welbourn R, Hollyman M, Kinsman R, Dixon J, Cohen R, Morton J, et al.
           Bariatric-Metabolic Surgery Utilisation in Patients With and Without Diabetes: Data from
           the IFSO Global Registry 2015-2018. Obes Surg. 2021 Feb 27. PubMed PMID: 33638756. Epub
           2021/02/28.

        2. Rutledge R. The mini-gastric bypass: experience with the first 1,274 cases. Obes Surg.
           2001 Jun;11(3):276-80. PubMed PMID: 11433900. Epub 2001/07/04.

        3. Currie AC, Askari A, Fangueiro A, Mahawar K. Network meta-analysis of metabolic surgery
           procedures for the treatment of obesity and diabetes. Obes Surg. In Press.

        4. Kaplan U, Romano-Zelekha O, Goitein D, Keren D, Gralnek IM, Boker LK, et al. Trends in
           Bariatric Surgery: a 5-Year Analysis of the Israel National Bariatric Surgery Registry.
           Obes Surg. 2020 May;30(5):1761-7. PubMed PMID: 32008257. Epub 2020/02/03.

        5. Dimick JB, Sedrakyan A, McCulloch P. The IDEAL Framework for Evaluating Surgical
           Innovation: How It Can Be Used to Improve the Quality of Evidence. JAMA Surg. 2019 Jun
           5. PubMed PMID: 31166583. Epub 2019/06/06.
    

Intervention name(s): Primary bariatric-metabolic surgery
Intervention type(s): Procedure
Intervention description(s): Primary bariatric-metabolic surgery
Observational model: Cohort
Time perspective: Retrospective
Sampling method: Non-Probability Sample
Study population: 
        All patients undergoing primary bariatric metabolic surgery within the UK National
        Bariatric Surgery Registry