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MGB - mini gastric bypass |
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"Mini" in the name of this procedure stands for the fact that it's almost
always done laparoscopically. The MGB more
resembles the old "loop gastric bypass" or Billroth II.
This is probably a bit safer than an RNY
gastric bypass because they don't cut the small bowel at
The MGB bypasses 6 feet of small bowel so that's more than a proximal gastric bypass. The downside of having bile in the stomach is about 25 percent of patients get bile reflux which while not dangerous is kind of yucky. This can be avoided by sleeping on a wedge the first year (most bile reflux stops after a year). A few years ago, the MGB got a very bad name when a patient started a vendetta toward the surgeon who pioneered the MGB. The patient claimed (but could not prove) horrific results from the procedure but it seemed that the vendetta may have had more to do with the surgeon not hiring this patient to work in his office than because the patient was as ill as claimed. And it seemed that the patient was most angry at not losing "enough" weight- fast enough- with the MGB, something which can happen with any gastric bypass. This patient later got a revision to RNY and reached extremely slender size which was apparently the main plan in having Weight Loss surgery (the gastric bypass is not really recommended for looks but people do all sorts of things - it is a free country). The surgeon sued the patient to stop their mis-informative website and won the suit - the website was taken down. This surgeon also took two years to run a double blind study proving the safety, and efficacy of the MGB over the Roux-n-y. Confusing, isn't it! Diagram of loop gastric bypass - mini gastric bypass variety |
the
duodenum -small bowel- like they do in the RNY and likely some of the pancreatic fluids and bile are channeled back
into the pouch which, like the RNY, is made from the ring of muscle
at the top of the stomach. This means SOME digestion may take place in
the stomach in MGB patients and the bile may neutralize the stomach acid
so LESS acid gets into the small bowel. This is a good thing. You don't
want stomach acid in the small bowel.