One Anastomosis/Mini Gastric Bypass as a New Treatment Option for Superior Mesenteric Artery Syndrome: First Case Series

Introduction: Superior mesenteric artery (SMA) syndrome is a rare condition, initially treated by conservativemanagement. Surgical treatment is indicated if conservative management fails. The surgical options includestraightening the duodenum by division of the ligament of Treitz (Strong’s procedure), Ladd’s procedure,gastrojejunostomy and, the most commonly performed duodenojejunostomy. Failure of surgical treatmentis frequently reported, usually due to misdiagnosis or associated gastroparesis and intestinal dysmotility. Oneanastomosis/Mini gastric bypass (OAGB/MGB) is a recognized bariatric operation. In this case series, I present theoutcome of OAGB/MGB performed for the treatment of SMA syndrome.Case presentations: One Anastomosis/Mini Gastric Bypass (OAGB/MGB) was performed for three patientsdiagnosed with SMA syndrome between September 2022 and March 2023. The diagnosis was confirmed withabdominal CT scan with contrast. Operative data and postoperative outcome were recorded.Results: The patients were 2 females and 1 male, with an average age of 25.3 years (range 23, 25, and 28years). All patients had refractory symptoms despite an average of 4 months of conservative management. Theaverage operative time was 100.3 minutes. No intraoperative complications, no in-hospital or 30-day postoperativecomplications were identified. Follow-up data showed resolution of vomiting, improvement of epigastric pain andgradual resumption of eating in all three patients. Patients lost an average of 8 kg and regained an average of 3.9kg in 12 months.Conclusion: Laparoscopic One Anastomosis Gastric Bypass is a safe and effective surgical treatment for SMAsyndrome and should be considered when surgical management is indicated.