"Mini Bypass"

So I had the gastric sleeve about two years ago and was afraid to have the bypass at that time. I am now two years out and had lost a total of 120#. I did gain back about 30lbs but still have a BMI of 31 and am "obese". I was just wondering if anyone had experience with converting their sleeve to a bypass? I have looked at several places in Mexico that do what is called a "mini bypass" so I was just curious about what others experiences were.

TIA

Mini gastric bypass is not that popular in the US. I've heard more about it happening in other countries.

Did find this article on National Institute of Health website. They were pretty much endorsing it as a procedure that should be supported in the US.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5022508/#__ffn_ sectitle

It has similar efficacy to the traditional RNY with fewer complications in some cases, as it's not an entirely reconstructed pouch. I think the RNY has better results long-term, though the difference is quite slight in the long run.

1. Mini bypass hasn't gotten very good results long-term. That's why many surgeons aren't doing it.
2. Getting a revision surgery with a BMI of only 31 is unethical, the only exception being extreme health issues associated with obesity, but being classified as "obese" doesn't justify something so drastic. I would question any doc who agreed to do it.
3. With a full functioning stomach that is only smaller, I have no idea why you would choose to tear it apart. The logical revision would be a DS.

In general, it is not necessarily infrequent that bariatric programs will do revisions or initial WLS on low BMIs if comorbidities are present and the insurance rider allows it - or if weight loss was insufficient. That's because they use BMI as the metric, and 31 is still obese.

While I don't necessarily think surgery is indicated for that either, it's not infrequent to see revisions for such individuals. It varies state by state, but at least the policies I've seen/worked with in IL, insurance requires the BMI for the *original* surgery would have been met during the first procedure. So, because mine was 78 for the sleeve, I was still approved for the DS before the GERD got totally crap, despite my BMI being much lower now by quite a bit. Not all insurance is this way, of course, so it really depends on the medical policy/evidence of coverage and the rider that was purchased.

The MBG actually has results long-term that are on-par with the other more frequently done surgeries. As to why more people don't do certain procedures, surgeons choose their primary surgeries based on things other than efficacy in some cases. A more significant one as to why it's not done is that many insurance companies will not cover it, and so they wouldn't get reimbursed for doing it in the US as often, likely because I don't believe it's an ASMBS approved procedure.

A logical version on the surface would be a DS I'd agree, however I think whether a DS is suitable depends on many more factors other than a sleeve being extant. Preserving the pylorus is always better from a surgical standpoint when possible, though, because of the metabolic issues that potentially happen without it.

Where's your scientific source for statement 1? In all my research I've not read that it has bad results long term. And bad results compared to what? Certainly not compared to RNY or VSG. There's been a lot of research and data collected outside the US. Just because it is not done very frequently in the US doesn't automatically make it a bad procedure. How and why it is not common in the US isn't due to poor efficacy.

I had the One Anastomosis Gastric Bypass in Mexico, which is equivalent to the MGB. I've had no complications and am below goal weight. If I end up gaining weight later, that will be due to my own poor food choices and not because of the type of gastric bypass surgery I had. After the honeymoon period wanes, it will be crucial that I don't consume excess calories, processed food or simple carbs. This is true for pretty much anyone post-WLS.

I have to admit that in my research the mini bypass has been effective as well. Actually the sleeve was initially designed as a first stage surgery for those severely obese and then to transition into a bypass.

I had a mini bypass ( proximal bypass) as a so-called lightweight ( 35 BMI with co morbities) and it has worked great for a lot of years. My malabsorption satill works and im convinced it has significantly contributed to my ability to maintain goal weight all these years.

A mini bypass is most decidedly NOT a proximal bypass. Almost all RNY are proximal bypass, so the word "proximal" is just assumed. Once in a while someone will have a distal bypass, which is only slightly different.

A mini bypass is a single anastomosis surgery that wasn't around until recently.