Let me say first off, I'm not trying to offend anyone. I'm legitimately researching this surgery and I see scores of happy patients who have had minimal complications. Yet in researching there are many people, even in the medical community, who say "MGB is sketchy" "Dr. Rutledge isn't a serious surgeron" "MGB is dangerous annd almost identical to the old loop bypass". Why is there such a divide? It is a HUGE discrepancy! I also posted about this on the MGB Yahoo Group but it never showed up on the board...that makes me feel even more suspicious! Maybe it was a technical glitch...but I think it may have been deleted by the administrator.  Have you had the surgey? Or do you have an opinion as to why the feedback is so conflicting? Please share!

Ariel, I am an MGB patient, having had surgery almost 3 years ago.  After having lost over 200 pounds with very few problems, I am truly satisfied with my decision.   I did a lot of research before making my decision.  I saw a doctor who does the "open" surgery first, and quickly decided this was not for me!  I researched the RNY, and was even on a waiting list for Emory Hospital's program.  I just happened across the CLOS.net website, and the more I read, the more I knew this was the surgery for me!  The statistics relating the lower death rate, shorter surgery and recovery time, the excellent follow-up and support after surgery, and, most importantly the fact that it is reversible if I made a terrible mistake, all convinced me that I was making the right decision. I, too, wondered why more people weren't aware of this. I believe the negative comments are coming from those who are not really educated as to the benefits and track record of this surgery.  I see so many problems posted on Obesity Help by people with terrible side effects, but I am totally pleased that I do not experience the diarrhea, throwing up or even more serious complications that I see requiring hospitalization! The Discovery Health Channel program on the surgery of actor Gil Girard seems to be putting out the word.  The MGB also has lots of patients who come from Canada since their health insurance program covers the MGB. I have met many MGB'ers and have gotten to know even more on the Yahoo support board, and I have yet to find anyone dissatisfied with their choice. I'm sure you could find answers to your questions at CLOS.net. One thing confusing to me, though, is the posts I see on here by folks who say they had the MGB but with doctors I have never heard of.  It is my understanding the the TRUE MGB was developed by Dr. Robert Rutledge and is performed by only him in Las Vegas and two other surgeons trained by him working out of Michigan and Florida.  I am curious as to whether these other docs are specialists in the procedure. Maybe on of the people who posted on here will explain that.    Sandy

I have wondered the same thing.  I have received responses from one member who says that he answered a question wrong on his Nevada application to practice and that makes him unethical.  As I read the legal documents it appear that Dr. Rutledge had 7 patients in 2001 make complaints and the NC board investigated.  After a broad survey of his patients they found no basis in the complaints, so they dropped the investigation.  The big ruckus was that he did not report that he had been investigated when he applied in NV, which he later agreed to go back and document.   I am not used to a doctor being quite so flashy, but after all MY research I have decided this is the least invasion and effective surgery.  If you looked at lap band failures and complications I am certain it would far out weigh those of MGB.  With all that being said, I am scheduled for surgery with Dr. Rutledge in August! 

  It was my understanding, too, that the report was just a misunderstanding that has been settled now.  I have complete faith in Dr. Rutledge and his abilities. Good luck with your surgery, and if you need a contact for your packet, please let me know.   Sandy

Thanks Sandy.  My packet was accepted already, and I had over 40 contacts all saying if they had to do it again, the only thing they would do differently was run and jump on the operating table without any  worry!!

First of all, let me say that Dr. Rutledge is not the only surgeon doing this great procedure.  I have seen hundreds of patients who have had this surgery performed by the physician I work for with minimal  to no complications.  I have seen lives changed.  Health problems disappear.  It is not even close to the old loop bypass.   Search further....I do hope the moderator will approve my post.

I have been researching the MGB for about three years and believe this is the right procedure for me. I am curious about these other Dr.s who are performing this operation. It has concerned me that only three in the country will perform it. It makes me feel skeptical that it is not a well accepted procedure. could you let me know who some of the other surgeons are so I could look into their practices also before I decide who to go with ? Also, I have a problem with cronic nausea. Will MGB make this worse?

The surgery is the same as the old Bilroth II, except that the loop of intestine is joined to the bottom of a longer pouch. The eary loop bypass had a smaller pouch with the loop joined towards the top of side of the pouch. This lead to pancreatic enzymes and bile to enter the esophogus area and cause serious complications. The surgery was abandoned as too risky  even for the outcome of weightloss. Dr Rutledge and a few others have started it up again, it's a fast surgery, and easy to preform. Dr Rutledge posts with great pride that he can finish the surgery in 35 minutes.  Click here: Surgical revision of loop ("mini") gastric bypass ...[Surg Obes Relat Dis. 2007 Jan-Feb] - PubMed Result

It is not the surgery that is the same as the billroth II but the connection, this type of connection was pioneered in the 1800's and is routinely used in about 16,000 non bariatric surgeries in the US per annum for things  like Cancer and Gun Shot wounds. The surgery is less invasive, less cutting leaves the original stomach intact and connects to the side of the small bowel rather than splcing it as they do in the RnY.  This is important as it makes it much easier to reverse an MGB (35 minutes) than a RnY ( 3 hours). The patient consent form of the MGB says that you agree to reverse the surgery if there is excessive weight loss, that is a responsible position.   I have seen two newspaper articles of RnY where patients have died of starvation.  I saw a RnY patient  at a recent meeting and she looked really too thin and quite ill. The other thing they do in the MGB is some very discreet work on teh vagus nerve terminal fibres, this is much more subtle than a vagotomy (complete cut of Vagus nerve) and leads to the reduction of Ghrelin which is a hormone related to hunger. So there are 3 WL factors in the MGB, reduced hunger, reduced capacity and reduced absorbsion.  Of course there are side effects as in all WL surgery but they want you about them and you confirm your understanding with a 17 pages consent form where you have to answer questions about the impact. (you do this for the packet as well). So why are people bad mouthing the MGB, well Doctors are full of ego and often knock each other and it might have something to do with the fact that alternative surgery costs more!

Dr. Rutledge has been sued many times in NC. If you go to the state cite to check his license, there is a wealth of information. There was also an expose about the mini-gastric bypass that hit several different newspapers and news stations here and also involved another doctor that was doing them who has now changed his name and moved to Michigan. I wouldn't let the man touch me with a 10 foot pole. As you can see, he has a public file with the North Carolina State Medical Board (all public information): http://www.ncmedboard.org/Clients/NCBOM/Public/Licensee_Details.aspx?&EntityID=26088&PublicFile=1<
He also made at least one omission on his original Nevada request for license (also public information): http://medboard.nv.gov/Meeting%20Minutes/September%204-5,%202003.pdf<
In the future, it might be a good idea to really research any bariatric surgeon you are considering, and include in that research states they used to practice in. He's well-known here in North Carolina. If you click on his public file, you can read all about it. There are also very good reasons why the vast majority of bariatric surgeons won't do this surgery and why the ASBS does not view the surgery as an acceptable one. It is also not a surgery that is covered by any reputable health insurer.

I know from personal experience that WLS is a big step, and requires a lot of research and study. I have been overweight all my adult life, and starting considering bariatric surgery in 2006, after my family doctor recommended it to me. He recommended an RNY surgeon in Atlanta. He had several patients that had used him, and they had all done well. I started doing my research in July, 2007, and joined a support group of the Atlanta surgeon, and also several other support groups, including the CLOS group. After a great deal of research, I decided that the MGB was the best for me in September, 2007, and started working on my application package. The package is very intensive in that it requires that you read the 147 page manual, and have and can demonstrate a complete understanding of the MGB procedure, as well as all the other types of WLS. It also goes into great detail about the negatives and positives of WLS. The process requires that you have an evaluation by your PCP, your cardiologist, and other specialists that you may use. You are required to have a psychological evaluation to make sure your emotional condition is as it should be. The CLOS site also has a wealth of information, instructional videos, etc, which make is easier to understand what to expect.
I had my MGB with Dr. Cesare Peraglie in Davenport, Fl on 12/7/07. At that time, my weight was 324, I had type II diabetes, high blood pressure, sleep apnea, aching joints, sore back, etc. After seven months, I am down to 221; diabetes has been resolved since immediately post-surgery, my blood pressure is improved, sleep apnea is gone, joints and back pain is gone. My wife had her MGB with Dr. Peraglie on 3/13/08, and she is also doing well. She is down 43 lbs after almost 4 months, and her blood pressure is much improved. Her only other co-morbidity of joint pain is gone. Neither of us have had any problems at all, and we are both grateful to have found out about the MGB, to have made the decision we made, and to have a surgeon of the quality of Dr. Peraglie. Part of our success is due to getting plenty of exercise, and eating a healthier diet too. Again, WLS is an important decision that should not be rushed into. For us, the MGB has been a great solution, and we would not change anything, except we wish we had done this much earlier.

Lynn in GA
12/7/07 - Dr. Peraglie - MGB
Hi: 329
Pre-op: 324
Now - 710/08: 221
Goal: 190

UPDATE: 8/2/09
Still no problems. I am no longer taking any medications for diabetes or high blood pressure. I reached my goal of 190 after 17 months, and have been running about 185 for the past 3 months--down about 140 lbs from my pre-op weight.  My wife is down about 80 lbs after 17 months, and is also doing very well. We are both still extremely happy with out decision to have the MGB with Dr. Peraglie. Our neighbor had the MGB with Dr. Peraglie on 11/20/07, and he is down from 275 to 180, and is also doing great. He says he only regrets not doing this years ago.

Lynn in GA

 The "studies" of patients that Rutledge touts are all based on self report of his patients. This is not good science. Anyone who has had complications from thier MGB, like myself and finds another doctor are no longer included in those surveys. He told me I had a 7 foot bypass, as it turns out, he bypassed almost my entire small intestine. For 3 years I was sick. I am not the only one. He is no longer working in Nevada. Does anyone know if there are any current lawsuits in Nevada against him? I am very curious. My Canadian health insurance paid for my revision from MGB to RNY, but I know several people in the states who need help and will have to pay for all tests and surgeries on thier own.

I had my MGB in 2008, I've had problems since.  It was only finally this past year that my doctor here in Canada has taken enough interest to send me for testing.  I had all kinds of tests done and the bariatric specialist here told me that the surgery was NOT done correctly and he's not sure why it was done the way it was.  SO, I did the obvious, contacted Dr R. and the response I got was less then desirable, he school me on what and how to eat but neglected to touch on the subject that other doctor's don't agree with my surgery.  I've not regained 40 out of the almost 100 pounds I had lost and have fallen into a deep depression.  I deal with my discomfort every day.  I have 6-10 BM daily and experience constant abdominal pain.  I don't know where to begin seeking help here. I'm sure for some folks this has been the greatest thing that could have happened to them  but for me it has been the worst decision I could have made.  Dr. Peraglie is a nice person, but I'm not so sure he did me justice.

What do you supposed the petroleum industry will do when more and more cars start running on battery power instead of petrol? Both can get you from point A to point B. But perhaps they will tout safety, horsepower, speed, etc?  My point is stakeholder have a vested interest for a reason.."they have a stake in it"!  Any conflict that puts that stakeholder at risk is going to cause a certain amount of trashing, etc. Look at the data. Look at mortality rates, complication rates, and in general QoL?

I had an MGB in Nov of 2005. I only wish I had done it 10 years before!!!