The thesis of Nienke Slagter focused on the one anastomosis gastric bypass (OAGB) procedure, a widely used surgical procedure for the treatment of obesity. Its objective was to offer valuable insights and refine various surgical aspects of OAGB, aiming to optimize techniques and improve postoperative outcomes.
Investigation into a late complication of OAGB, biliary reflux, revealed a beneficial effect of an anti-reflux suture. Furthermore, the optimal length of the biliopancreatic (BP) limb in OAGB surgery was investigated to achieve optimal postoperative outcomes by maximizing weight loss while minimizing adverse effects.
Initially, the accuracy of laparoscopic measurement techniques for bowel length determination was assessed. Following investigations examined the technique of adjusting the length of the biliopancreatic (BP) limb based on preoperative BMI. However, this method did not produce the intended postoperative results. The thesis introduced the TAILOR study, a randomized clinical trial investigating if tailoring the BP-limb length according to total small bowel length (TSBL) offers advantages over a fixed BP-limb length in terms of weight loss, nutritional deficiencies, and resolution of comorbidities.
Preliminary findings show the feasibility and safety of this approach, although one year after surgery, an adjusted biliopancreatische-limb length based on TSBL did not result in superior postoperative outcomes compared to a fixed BP-limb length. However, the five-year results of the TAILOR study will be essential for drawing definitive conclusions.
