Mini Gastric Bypass Surgery – What’s Wrong with It?

by Jim
(Sarasota, FL, USA)

Why is mini gastric bypass surgery not more popular? Is there some inherent problem with it?

Based on all of the research I’ve done, it seems to be a great option with good weight loss, comparable resolution of health problems and relatively low complication rates. And the costs look to be much less than gastric bypass or other procedures.

But there are very few clinics in the United States who offer it. Why is no one talking about this procedure?

The only reason I could find is that it’s an easier procedure so it is more likely that inexperienced surgeons would be performing it. But that doesn’t explain why experienced surgeons would not offer it.

I’ve also read that more long-term research is needed to confirm its positive results. But lack of long-term research didn’t stop gastric sleeve surgery from being adopted.

I look forward to your insights.


Comments for Mini Gastric Bypass Surgery – What’s Wrong with It?

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Thank you

by: Jim

Dr. Bessler,

Thank you for taking the time to respond.

Your feedback was very helpful.


Response to Mini Gastric Bypass

by: Marc Bessler, M.D. Professor of Surgery, Columbia University

Dear Jim,

Your question is a good but not simple one.

Mini-Gastric Bypass is a version of gastric bypass that does not use a Roux-Y configuration. This means that the bile and digestive enzymes are not diverted away from the stomach which can lead to bile reflux gastritis. This problem can cause pain that is hard to treat and perhaps increase cancer risk in the stomach pouch.

The mini bypass also usually bypasses much more of the intestine than a standard gastric bypass and theoretically would lead to more vitamin and mineral deficiencies.

As far as cost goes there should only be a few hundred dollars of increased costs with a standard gastric bypass.

All this being said it may be lack of experience with a procedure that seems to have little if any advantage over a standard bypass that leads most US surgeons to avoid mini-bypass.

I hope this helps.

Best of luck,

Marc Bessler, M.D. FACS, FASMBS

long island bariatric surgeon

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DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

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Second Surgeon Response to "Mini Gastric Bypass - What's Wrong With It?"

by: Dr. Chris Cobourn

I would respectfully disagree with Dr. Bessler on the concern of bile gastritis. Bile in the stomach is not a problem and is a normal condition in many people. The issue is bile in the esophagus which is a rare issue with the MGB unless the pouch has been made too small. Many of the case reports in the literature describe a small pouch made by a surgeon that is more comfortable with the Roux en Y procedure which can lead to bile in the esophagus.

Experienced MGB surgeons know to make the gastric pouch large (divide at the Incisura or Crows foot) area of the stomach to prevent this problem.

The MGB has been shown to be just as effective as the Roux en Y procedure but with a markedly lower rate of complications such as anastomotic leakage, bleeding, and internal hernia. There is also a lower rate of marginal ulcer (with bleeding and pain) than with Roux en Y.

Dr. Chris Cobourn
SmartShape™ Weight Loss Centre

Related Pages:

  • Weight Loss Surgery Complications - 11 Actions to Reduce Your Risk
  • 7 Types of Weight Loss Surgery - All You Need to Know

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