mini gastric vs regular gastric

Can someone please tell me what the difference between MINI Gastric and the REGULAR Gastric Bypass is??? Thank you so much, in advance :)

Nichole,

There are just too many advantages of the MGB to explain here, but if you will go to CLOS.net, you will find the information you need. Learn all you can, then make an educated decision. After losing almost 200 pounds, I am very happy with my choice.

Sandy

Nichole,

You may also go to www.mgb-surgery.com which is Dr. David Hargroder's website.  He was trained by Dr. Rutledge.  He is in Missouri.   Basically, MGB is laparoscopic and the GB is an open surgery...however, there are other differences in all of the gastric surgeries.  Please check out all of them and be comfortable and sure of your choice.

That is simply not true.  Nearly all RNY gastric bypasses are laparoscopic these days.

The MGB is a somewhat controversial procedure in some circles.  Anyone considering it should really make sure they understand the history and anatomy of this procedure.  It's heavily marketed because it's easier for the surgeons to perform.  Whether it's also better for patients is yet to be proven conclusively, but you can do your own research and reach your own conclusions there.  (Consider the sources of whatever you read though!)

Anyone considering any type of bariatric surgery should really make sure they understand the history and anatomy of all types of surgery.   Any surgeon would want the absolute best for their patient and want them to be completely informed.    The question was....what is the difference between Gastric Bypass surgery and the Mini Gastric Bypass.  I just wanted to answer that question. 

This is the first time I have heard of the MGB  being  more controversial than the other bariatric surgeries.  However, that being said, I guess "in some circles" it may very well be.

We encourage our patients to check out and study all types of bariatric surgery.  These include the GB, RNY, the sleeve,  Lap Banding and all others.

As for it being easier for a surgeon to perform.  A surgeon tasks a risk any time they do surgery.  Whether it be bariatric, gallbladder, heart, lung, etc.  Surgeons do not do any surgery because it is "easier".  If they do, they shouldn't be a medical doctor to start with.

I went to both sites posted and I'm trying to figure out the difference between the MGB and the DS? From what I can tell, they stomach is more or less sleeved and the pylorus is retained so no dumping??  And you have the small intestine bypassed... so isn't this similar to a DS?

Sorry - I just found this type of surgery and I can't seem to get more clear information.  I thought I had settled on a vertical sleeve gastrectomy but this now has caught my attention.

 Because in the VSG the excess part of the stomach is removed, reversal is not possible. In the MGB the sleeve is sectioned before the duodenum and the redundant part left intact. This means that if for any reason in the future you must regain all previous absorption due to illness or malnutrition, you can have a reversal done and regain full pre-surgical absorption. As well no part of the small intestine is removed in the MGB so it can be revised to a shorter or longer intestinal bypass should the need arise.

I hope this helps. 

Carey

No part of the intestine is "removed" during the DS surgery...the intestinal part of the DS is reversible/ adjustable.

Nichole,

Please check into the lap band (realize band) before doing either of these surgeries.  MGB is not paid for by any insurance.   It is not an approved surgery.  My daughter had the MGB and a year later had a revised MGB to take up more of her intestines.  This was done in Vegas and she came home with an infection.  She spent two weeks in the hospital here and almost died in May 08 and is still not out of the woods.  All her levels are down and everything she eats goes right through her leaving no notable nutrition in her body.  They have a low mortality rate for the MGB   but it is because they don't count all the people who die after the surgery that they do not take care of.  After the MGB, you are on your own.  They do no follow up and other doctors have to make the best of a bad situation.  With the MGB you are left with a vertical pouch and food doesn't stay in long enough for nutrients to be absorbed.  Even though her weight is down, her life is in jeopardy.

I know I am replying late in this post. I went to your profile to see you have decided on gastric bypass, based on your BMI of 72 chosing this vs band and due to insurance and your research overall! Know that all surgeries have risks and benefits. Making an informed and educted decision is recommended fr each of us individually.

We all have biases, we all have opinions and we are all right for ourselves; judging choices of others is not helpful. Sharing our experiences, strenght and hope can be helpful IMHO.

I am pro WLS, whatever that means to an individual. I am glad we have choices! I originally researched the lapband after that I decided for me I wanted lap Gastric Bypass. Happy with my choice 6 yrs out....I can say I now beleive that BPD/DS would be my choice based on what I now know but in 2002 I didnt have that choice with insurance or local surgeons.

You can spin statistics anyway you want...I can share reasons that the lap band seems great or why it seems a horrible choice...I can do the same for any surgery....GBP, Sleeve, DS, MGBP etc......

For instance one article stated Lapband and RNY at 5 yrs had both 50% excess wt loss, sure because that study did not include lapband failures, remembering that 30% of those with bands get them removed (complications, failure etc) when that is factored in RNY at 3 yr was 73% excess wt loss and bands were 37% big difference (different spin see!)...

Longer one has a band higher complicaation rates go, so early on seem low vs bypass later on exceeds greatly!

BPD/DS I feel is the surgery of choice for super morbidly obese, it has record of greatest excess wt loss over time...I agree a person with BMI over 50 the stats I have seen show that it isnt enough to impacct comorbidities, 30-50% excess wt loss when one is 200# or more overwt is not worth risk, the Sleeve as step one and then BPD/DS as step 2 seems the way to go for many..Lap Bypass seems to not get Super Morbidly obese (BMI > 50) close to normal BMI either....

Sleeve and band may give same excess wt loss but sleeve changes internal hormonal mileu having greater impact it seems on metabolic issues like diabetes, appetite suppression. Bands are contraindicated with autoimmune disease like Lupus, Gastric sleeve is of choice fo those with Chrones disease over other malabsorbtive surgeries.....

I agree in some circles ANY bariatric surgery is 'controversial'. What I think others mean by MGB being more so is this: see article in Obesity Surgery Jouranal 2001
 

Obes Surg. 2001 Dec;11(6):773-7.
Mini-gastric bypass controversy.
Fisher BL, Buchwald H, Clark W, Champion JK, Fox SR, MacDonald KG, Mason EE, Terry BE, Schauer PR, Sugerman HJ.
(Email me I have it in PDF form)

http://www.gastricbypass.com/SurgicalOptionsForMorbidObesity .htm
Loop Gastric Bypass ("Mini Gastric Bypass")
This form of Gastric Bypass was developed years ago, and has generally been abandoned by nearly all bariatric surgeons as unsafe -- several years ago, a consensus of the American Society for Bariatric Surgery was that the procedure should never be performed. 
Although easier to perform than the Roux en-Y, it creates a severe hazard in the event of any leakage after surgery.  It seriously increases the risk of ulcer formation, and irritation of the stomach pouch by bile, as well as risking the potential of esophageal cancer.  Many persons who underwent this procedure in the past have required major revisional operations to correct severe discomfort and life-threatening pathophysiologic effects.  Most bariatric surgeons agree that this operation is obsolete, and should remain defunct.
This operation has been resurrected, in order to make the laparoscopic procedure easier to perform, by possibly less-skilled surgeons.  As shown by the single surgeon performing the procedure, the gastric pouch is excessively large, which may lead to loss of weight control over time.
A fundamental principle of laparoscopic surgery is that the underlying operation should not be compromised or degraded, in order to accompli**** by using limited access techniques.  The loop bypass does not meet this standard.  There is no reliable long-term data to support use of this anatomic variation.

http://clos.net/lib/19-roux-en-y/mgb_vs_rny.htm
This is the differences (remember who is spinning here).
Insurance doesn't pay consider that and perhaps why...they will pay for bands, bypasses and DS or Sleeves more now..Do you have about $17K to spend?

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From 2001 in a local NC newspaper.

http://abclocal.go.com/wtvd/news/032901_NW_stomachsurgeryupd ate.html
 

Durham Regional Bans Controversial Stomach Surgery By Jim Hill A stunning turn of events surrounding a Triangle doctor who performs a controversial stomach bypass surgery-- which helps severely obese people lose weight. Durham Regional Hospital-- where Dr. Robert Rutledge performs this operation-- decided to ban the procedure. For the past three years, people from all over the world have come to Durham Regional to have the stomach bypass. Wednesday was the last day the procedure was performed at the facility.

Dr. Robert Rutledge had performed 1300 mini-bypass surgeries on people wanting to lose weight before officials at Durham Regional suspended the procedure Thursday. Officials at Durham Regional told Eyewitness News the decision was based on information the hospital had been looking at-- and questions that had been raised by insurance companies.

This comes after Blue Cross, Blue Shield administrators announced they would no longer pay for Rutledge's procedure because of the long-term complications of the surgery of which some of their clients complained.

Now, some patients who had been scheduled to undergo the procedure at Durham Regional are left with questions. "They're holding our lives in their hands right now," said Debbie Beck of Elk City, Oklahoma. Beck was scheduled to have the surgery on April 18. "Some of us are to the point where we are really sick and we have got to have this surgery done to get healthier."

Patients who were scheduled to have this procedure done were notified by Durham Regional and told to contact Dr. Rutledge. Eyewitness News also tried to contact Dr. Rutledge and had not yet received a return call by our 11:00 p.m. broadcast time Thursday night.

Online producer: Shaun Chavis Benchi

Last Updated: Mar 30, 2001

This doctor now works independently out of Statesville NC and is expanding his business into other states. He does not accept insurance because the insurance companies will not pay for his procedure.
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