Why One Anastomosis (Mini-) Gastric Bypass May Cause Less Immediate Dumping than Roux- En-Y Gastric Bypass: An Opinion

The laparoscopic one anastomosis (mini-) gastric bypass (OAGB) is quickly gaining popularity as a bariatric-metabolic operation. One of the main reasons of the increase in popularity is without any doubtthe technical ease of the procedure. However, there are other possible benefits that may help explain the increasing numbers. One of the benefits may be the alleged reduction of incidence and importance of the immediate dumping syndrome, which is still considered one of the major drawbacks of the gastric bypass [1]. Nowadays, the difference between the Roux-en-Y (RYGB) and OAGB tends to be limited to the interposition of a 60 cm long alimentary limb in the former, whereas this limb, by definition, does not exist in the latter. Indeed, “modern” versions of the RYGB imply a long (150cm) biliopancreatic limb -which happens to be the recommended length of the biliopancreatic limb in the OAGB-, and a rather short (60cm) alimentary limb [2]. Even the gastric pouch of the RYGB more and more resembles the pouch of the OAGB, as surgeons make the pouch longer and skinnier, and certainly perform a rather wide gastro-enterostomy [3].