Controversy Surrounding ‘Mini’ Gastric Bypass

Abstract

Mini gastric bypass is a modification of Mason loop gastric bypass with a longer lesser curvature-based pouch. Though it has been around for more than 15 years, its uptake by the bariatric community has been relatively slow, and the procedure has been mired in controversy right from its early days. Lately, there seems to be a surge in the interest in this procedure, and there is now published experience with more than 5,000 procedures globally. This review examines the major controversial aspects of this procedure against the available scientific literature. Surgeons performing this procedure need to be aware of these controversies and counsel their patients appropriately.

Gastroesophageal reflux disease in the obese: Pathophysiology and treatment

“…Although a significant percentage of bile gastritis occur, symptomatic outcomes are controversial. 96 Sleeve gastrectomy. Sleeve gastrectomy is the most controversial procedure in terms of its effects on GERD.…”

The Name of Mini Gastric Bypass

“…As the first bariatric unit within the National Health Service of United Kingdom performing this procedure, we wished the debate and discussions on this procedure were held at a different level where we actually addressed the dilemma in the minds of the surgeons and the patients rather than confuse them further. When it comes to name, even though we would have preferred to call it modified loop gastric bypass [4] emphasizing its similarities with Mason's original loop gastric bypass, we were concerned about the confusion it would cause in the minds of surgeons and patients and hence resigned ourselves to the fact that this will be yet another misnomer scientific community will have to live with. Moreover, let us not forget that Rutledge, the inventor of this procedure, named it mini gastric bypass [5].…”

“…Increasing body of published evidence [6][7][8] has now satisfied most of the controversial aspects that have plagued this procedure from its early days [4]. It is now more or less settled that patients undergoing MGB rarely suffer with symptomatic biliary gastro-oesophageal reflux and, when it happens, it is probably due to the construction of a shorter pouch by surgeons in their learning curve with this procedure.…”

“…Closest surgical model of MGB is Mason's loop gastric pouch [4]. Both procedures have loop reconstruction, and both were/are carried out for morbidly obese subjects.…”

A Safe and Efficacious Alternative to Roux-en-Y Gastric Bypass for the Treatment of Morbid Obesity and Type 2 Diabetes - One Anastamosis / Mini Gastric Bypass

“…Rutledge [12] reported malnutrition in 1.1% of his comparative studies and systemic reviews. [33][34][35][36] LMGB is effective in achieving weight loss; BMI reduction and EWL range 57-92%, for up to 6 years according to the reviewed literature. When compared to RYGB, Lee [13] found EWL to be comparable in 1 study but far more superior to RYGB in another of his study [20].…”