Laparoscopic “Mini-gastric bypass” (MGB)
This is otherwise known as the “One Anastomosis Gastric Bypass”, “Single Anastomosis Gastric Bypass” or “Omega Loop Gastric Bypass” dependent on which continent it is performed.
Dr Robert Rutledge from the USA first developed the mini gastric bypass procedure in 1997, as a modification of the standard Billroth II procedure. A mini gastric bypass creates a long narrow tube of the stomach along its right border (the lesser curvature). The remnant stomach is left to drain naturally into the small intestine. A loop of the small gut is brought up and hooked to this tube at about 180 cm to 200 cm from the start of the intestine. Weight loss can therefore be tailored, as it is dependent on the length of this loop.
Numerous studies show that the loop reconstruction (Billroth II gastrojejunostomy) works more safely when placed low on the stomach, but can be a disaster when placed adjacent to the esophagus. Today thousands of “loops” are used for surgical procedures to treat gastric problems such as ulcers, stomach cancer, and injury to the stomach, without long-term adverse problems.
The Mini Gastric Bypass uses the low set loop reconstruction and thus has rare chances of bile reflux.
The Mini Gastric Bypass is an alternative to the Roux en-Y procedure due to the simplicity of its construction, and is becoming more and more popular because of low risk of complications and good sustained weight loss. It is equivalent to Roux en Y Gastric Bypass in the control of Type 2 Diabetes.
Unlike, the Roux-en-Y gastric bypass if problems were to emerge, such as bile reflux or nutritional deficiency, the Mini Gastric Bypass is straightforward to reverse laparoscopically.
It has been estimated that 15.4% of weight loss surgery in Asia is now performed via the Mini Gastric Bypass technique. The International Federation for the Surgery of Obesity and Metabolic Disorders, endorse the Mini Gastric Bypass as an alternative bariatric procedure.
Dr George Petrou, is a provider of the Mini Gastric Bypass on the Mid North Coast NSW.