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ANZMOSS - ANZGOSA 2020 Virtual Conference
ANZMOSS – ANZGOSA 2020 Virtual Conference
ANZMOSS - ANZGOSA 2020 Virtual Conference
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Minimising the Mini Gastric Bypass: Enhanced recovery and cosmesis.

Description
AIMS
The Mini Gastric Bypass (MGB) was so named as a reference to a minimally invasive form of Gastric Bypass, now generally referred to as MGB-OAGB, yet often involves as many as three 12mm ports and two 5mm ports.   The author has applied reduced port and mini-laparoscopic approaches to this procedure, resulting in minimal pain, scarring and length of stay together with excellent safety and weight loss outcomes.  The technical aspects and outcomes will be discussed.

METHODS
A single surgeon series of reduced port (number and size) MGB-OAGB cases will be presented, focusing on videos of key points of technique. Only one 12mm umbilical port was used in each case, with three other ports comprising either 5mm or even mini-laparoscopic instruments.  Complementary non-surgical strategies to enhance recovery will also be discussed. 

RESULTS
This single surgeon complete series demonstrated outcomes with short lengths of stay, no staple line or anastomotic leaks, bleeds, transfusions or returns to theatre, and with excellent cosmesis.  26% of patients were revisions from previous operations such as gastric banding, vertical banded gastroplasty or even slipped Nissen fundoplication. Patient ages ranged from 18 to 70, with average length of stay of 1.79 days including revision and interstate patients, and virtually no discharge opioid analgesia.    

CONCLUSION
Minimising port numbers and sizes results in less pain and therefore less reliance upon narcotic analgesia and its associated side effects.  Length of stay is also minimised with patients benefiting from enhanced recovery and near-scarless outcomes without compromising safety. 

KEYWORDS
MGB-OAGB, Reduced port, Mini-laparoscopic, Treatment outcome