What is the difference between...

What is the difference between a Mini gastric bypass and gastric bypass just doing some reading and came across the wording mini

Mini-Gastric Bypass

The field of bariatric surgery has become a very popular and competitive area of medicine, as the incidence of morbid obesity continues to rise and bariatric surgeons respond to the demand for effective treatments. While many doctors prefer to perform the bariatric procedures that have lasted through years of medical scrutiny, other doctors are developing alternatives.

One such development is the mini-gastric bypass (MGB), a variation of gastric bypass surgery, which was developed in 1997 by Dr. Robert Rutledge, a twenty year career professor of surgery at the University of North Carolina at Chapel Hill. The mini-gastric bypass reverts back to the simpler loop reconstruction of earlier gastric bypass procedures, but with some improvements.

In the ten years since it’s development, some 4,000 people have chosen the MGB procedure. To put the number in perspective, ten years ago, 20,000 bariatric surgeries were performed annually; today, some 200,000 bariatric procedures are performed each year in the United States.

• In 2005, actor Gil Gerard underwent a mini-gastric bypass operation. His operation and subsequent progress was filmed by Discovery Health channel. The surgery was successful and helped him lose 140 pounds of excess weight.

The Mini-Gastric Bypass surgery involves:

• Creating a long narrow gastric pouch
• Connecting new stomach to the side of the small intestine, bypassing 6 feet

According to Dr. Rutledge, his variation offers the following benefits:

• Lower Cost: his version of gastric bypass costs less - $17,000 versus the $25,000 to $30,000 charged for the standard gastric bypass procedure; some patients may qualify for the same day out-patient procedure which costs $9,500
• Shorter operation: surgery is less than 45 minutes
• Simpler operation: fewer staple lines
• Minimally invasive procedure: surgery is performed laparoscopically
• Shorter hospital stay: usually no more than 24 hours
• Low surgical risks
• Minimal surgical pain
• Less blood loss than in the Roux-en-Y, Open or Laparoscopic
• Can be easily reversed or revised
• Decreases hunger (hunger hormone - Ghrelin)
• Increases satiety (feeling full - Peptide YY)
• Excellent long-term weight loss results

Risks and Side Effects

Although the surgery is considered relatively safe, all major surgery involves some degree of risk. Some of the possible problems are similar to those of RNY, including leak, bowel obstruction, blood clot, and pneumonia. MGB patients must also be monitored for calcium and iron deficiencies as are RNY patients.

Choosing a MGB Bariatric Surgeon

The complete system of pre-operative, intra-operative, and post-operative care that make up the mini-gastric bypass surgery is owned exclusively by Dr Robert Rutledge and his Centers for Laparoscopic Obesity Surgery (CLOS). The “Mini-Gastric Bypass” system is restricted to surgeons and bariatric programs that have completed training and received permission from Dr. Rutledge to do so. The training is specifically designed to “deliver excellent patient care and avoid confusion with other surgery of questionable quality.” In turn, Dr. Rutledge receives a portion of the fees for each surgery performed by approved bariatric surgeons.

Controversy and Considerations

Individuals looking into the MGB need to be aware that it is a newer procedure and not widely accepted. Many bariatric surgeons are concerned about the relative safety of the procedure, including the possibility of bile reflux which can lead to severe ulceration of both the stomach and the esophagus. Newer procedures must be considered with caution, as the history of bariatric surgery is full of procedures that seemed promising but were later found to be failures.