Nov 18, 2010 Vanessa Barnes
Laparoscopic Gastric Bypass Surgery - ? Visuals Unlimited/Corbis
Despite the allure of the more simplicistic loop gastric bypass surgery, the American Society of Bariatric Surgery deems the procedure unsafe. Very few bariatric surgeons perform this modified version of weight loss surgery viewing it as obsolete and maintain traditional Roux-en-Y as the gold standard.
What Is Mini Gastric Bypass Surgery?
MGB combines two surgeries: Collis gastroplasty--lengthening of the esophagus by creating a tube from the upper part of the stomach-- and Billroth II loop gastrojejunostomy-- connecting the small intestine to the stomach.
Essentially, a narrow, long pouch is formed and reconnected to the intestines about 6 feet from the stomach without actually severing the small intestines. No food is emptied into larger, sectioned-off portion of the stomach or small intestine limiting calorie absorption.
The procedure takes between 30 to 60 minutes to complete and patients are released from the hospital within 24 hours after surgery.
Roux-en-Y Gastric Bypass versus Mini-Gastric Bypass: The Short VersionIn RNY gastric bypass, the small intestine is completely severed and reconnected to the stomach creating a "Y" shaped bypass. A small round pouch is created by stapling the stomach. Traditional gastric bypass surfery is considered more invasive than MGB. The round pouch is more easily stretched with an incremental increase of food intake than with MGB.
MGB is less invasive than RNY allowing for a faster recovery time and a cheaper gastric bypass surgery. This loop gastric bypass procedure is easily reversed. The long and narrow pouch as opposed to the round pouch created in RNY, more efficiently mitigates the sensation of hunger. Patients feel fuller faster.
MGB CandidatesThe minimum requirement for patients choosing Mini-Gastric Bypass is to have a body mass index of 35 or higher (100 pounds overweight or more).
How Much Is A Mini-Gastric Bypass?In 2010, the MGB procedure cost for an outpatient procedure was around $9,500 compared with the RNY procedure costing around $25,000 to $30,000 on average.
Mini Gastric Bypass Complications and ControversyOne of the primary concerns with the Mini-Gastric Bypass procedure is bile reflux into the esophagus. Bile irritates the esophagus and stomach leading to severe ulceration. Persistent reflux prediposes patients to developing esophageal cancer.
Other complications include: severe anemia, bleeding, leaking from staples in the stomach, severe malnutrition, blood clots, hyperglycemia, persistent nausea and vomiting, gall stones, kidney stones, gas, food intolerance (especially to dairy products), hernia at incision site, reflux, bowel obstruction with massive infection, knotted intestines, and ulcers.
MGB is a New Prodecure
The loop gastric bypass surgery is relativey new compared with more widely accepted weight loss procedures. Short-term weight loss in the super-super obese appears to be successful but long-term data will require more surgeries and time. As with any surgery, the benefits must be weighed against the risks.
References
- American Society for Metabolic and Bariatric Surgery: "Complications Following Mini-Gatric Bypass In 2,804 Patients: Part 1 Short - Term (Less Than 30 days), (accessed November 18, 2010)
- GastricBypass.com: "Surgical Operations for Morbid Obesity Gastric Bypass, Roux-en-Y" (accessed November 18, 2010)
- The Centers of Laparoscopic Obesity Surgery: "Sample Complications 5 Years after Mini-Gastric Bypass Surgery" (accessed November 18, 2010)
- U.S. National Library of Medicine National Institute of Heath: "Laparoscopic Mini-Gastric Bypass (LMGB) in the Super-Super Obese: Outcomes in 16 Patients (accessed November 18, 2010)
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