mini bypass

Is the Mini Bypass WLS Procedure Right For You?

November 27, 2017

There’s a lot of buzz about the Mini Bypass recently and sometimes misinformation gets out that can cause confusion. There are many questions about what the Mini Bypass is and why a doctor would recommend it.

There are many factors that should be considered before you make the decision of which bariatric surgery procedure to have. Most of the time, the decision is reached as a joint effort by you and your surgeon. The process of choosing which procedure is best for you involves weighing the risks involved as opposed to the benefit produced. The proper decision considers your health history, co-morbidity issues, and many other factors. You have several choices when it comes to weight loss procedures. I’ll try to explain the most important reasons that one procedure may be better than another for you and your health, and it’s not about price.

Let’s dig into the facts so you can make a better, more informed decision.

Factors to Consider for the Mini Bypass WLS Procedure

Your age:  If you are over 55 years old, the Mini-Bypass may be the right choice for you. It is a safer procedure than a full RNY Bypass because it is quicker. You’re in the operating room and under anesthesia for a shorter period of time. This means there is less risk of immediate or early complications that can occur than with the RNY Bypass. Most surgeons will not perform the RNY Bypass on patients over 55 because of the increased risk involved. If you are over 55 years old, you should consider the Mini Bypass or the Vertical Sleeve Gastrectomy (VSG).

Issues with GERD or acid reflux: GERD or acid reflux is one of the possible long-term side effects of the Mini Bypass.  If you have those issues now, the Mini-bypass is probably not the right procedure for you.

Complications and risks:  Early complications are those that happen in the operating room, the recovery room or soon after surgery. The time under anesthesia is a factor and should be considered. The longer you’re under anesthesia, the greater chance of immediate or active complications. If you have co-morbidities such as coronary heart disease, sleep apnea, kidney disease or hypertension, the risk of early complications goes up. Your surgeon will carefully consider these factors when making a recommendation on which procedure is best. The Gastric Sleeve (VSG) is a less complex procedure so it is also the fastest.

The Mini Bypass involves one new intestinal connection (Anastomosis) as opposed to the RNY Bypass which has two connections or the Sleeve that has no new connections. Every connection increases both the time under anesthesia and the complexity of the procedure as well as the early and late risks involved. Each connection is another possible point of failure where complications like hernias, ulcersleaks, and strictures can happen.  Although these complications are rare, they should factor into the decision as to which procedure is the best fit for you.

Your BMI:  The sweet spot BMI for the RNY Bypass is between 40 and 55. If you have a higher than 55 BMI, the Mini Bypass may be right for you. Sometimes patients with a very high BMI use the Sleeve as an intermediate step. Some very high BMI patients will do well with the Sleeve, but some will only lose to a certain point and stall. They may need the malabsorption that a Bypass will provide. Revising to Mini-Bypass is sometimes recommended for those patients. With the Sleeve, your BMI may have reached the range for a successful RNY Bypass, but the other factors we discussed above may make that procedure too risky. For those patients with a BMI lower than 40 and no co-morbidities, the Gastric Sleeve may be the best choice.

Your health and success are always the most important factor. Your procedure choice depends on many different factors.  Knowing the facts and making an informed decision with your doctor is important. Choosing the best procedure is always a decision that you make once you have all the facts and a recommendation from your doctor.

I hope that I have given you some clear reasons for choosing one procedure over another.  No matter what you finally choose, I wish you much success on your journey to a healthy weight and a sustainable future.


Dr. Jesus Elias Ortiz is a bariatric surgeon who practices at A Lighter Me Mexico Weight Loss Surgery and has over 7 years experience in bariatric surgery. He has performed over 1,000 bariatric surgeries (including the Lap Band surgery, Gastric Bypass Surgery, Mini Bypass, the Gastric Sleeve, Duodenal Switch and Gastric Sleeve Plication). Dr. Ortiz is certified in the Allergan gastric band (one of only 2 FDA approved gastric bands) as well as certified in the Vertical Sleeve Gastrectomy, Gastric Bypass and Duodenal Switch.