Mini Gastric Bypass Surgery
Nevada surgeon Dr. Robert Rutledge devised and is marketing heavily what he calls the mini gastric bypass surgery. He says the procedure is safer, takes less time and is less expensive than the roux-en-y procedure. It also involves a shorter hospital stay, often only 24 hours (as opposed to the five days or so required with traditional gastric bypass). Since 2003, he has opened mini gastric programs at hospitals in Arkansas, California, Florida, Michigan, Missouri, and North Carolina in addition to Nevada.
The procedure differs from roux-en-y in the way in which the intestines are re-routed. It's rather complicated to explain in lay terms, but the mini procedure uses a bypass that is similar to what was used in obesity surgery in the 1970's called the Billroth II.
The only randomized clinical trial we could find was "Laparoscopic Roux-en-Y Versus Mini-Gastric Bypass for the Treatment of Morbid Obesity". The Taiwanese researchers chose 80 patients who met the American National Institute of Health (NIH) guidelines, and randomly chose 40 to have roux-en-y and 40 to have the MGB. The followed up at one year and two years post-op, and reported their findings in the July 2005 Annals of Surgery. The conclusion of the researchers was that, "Both LRYGBP and LMGBP are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. LMGBP is a simpler and safer procedure that has no disadvantage compared with LRYGBP at 2 years of follow-up." Note that LRYGBP stands for laparoscopic roux-en-y gastric bypass while LMGBP stands for laparoscopic mini gastric bypass. This does sound very promising, but think about all of the studies that have told us that butter is good, butter is bad; a glass of wine per day is great for your health, a glass of wine per day is terrible for your health; eat eggs, don't eat eggs.
The point is that one study is not definitive.
Dr. Rutledge has published two articles in the Obesity Surgery, reporting glowing success on first 1274 cases followed for two years and later 2410 patients followed for six years. Although the reports are great, you must keep in mind that the results are self-reported. Dr. Rutledge or one of the doctors he has trained sends out questionnaires, and the the data is based on them. Unfortunately, people do not always accurately report things like their weight, and may not be aware that a medical issue they've had is a complication of the original procedure.
We don't want to sound unduly negative about the mini gastric bypass surgery. There is a danger of complications with any weight loss surgery. The Guru considered it, but decided against it because she didn't feel there was enough solid information about it to feel comfortable. We would like to see more randomized clinical trials conducted.
Here are some other pages you may find interesting:
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