This document summarizes the results of a study on 6,385 patients who underwent mini-gastric bypass (MGB) surgery over 15 years. The mean preoperative weight was 143kg and BMI was 47. Complications occurred in 4.9% of patients, with 0.7% having leaks. Long-term follow up found 78% excess weight loss on average and only 4.9% weight regain after 10 years. The study concludes MGB is an effective and low-risk bariatric procedure that can also be easily revised if needed.

1. 6,385 Consecutive Mini-Gastric
Bypasses: 15 Years Later
Dr. Rutledge, DrR@clos.net

2. First International Consensus
Conference on the Mini-Bypass / One
Anastomosis Bypass
Paris 2012 October 18-19
Email DrR@CLOS.Net

3. The Mini-Gastric Bypass
• In spite of initial skepticism;
there is growing evidence that
mini-gastric bypass (MGB) is a
safe and effective procedure
with many of the features of an
ideal bariatric surgery.

4. Methods:
• Outcome and long-term follow-up of
a consecutive cohort of patients who
underwent MGB are reported.

5. Results
• The data on 6,385 patients who underwent
MGB from September 1997 to June 2011
were reviewed.
• Mean preoperative weight
(+/- Standard Deviation) was
143 +/- 31 kg,
BMI 47 +/- 7. &
83% were female.
• Mean operative time 41 minutes and
median length of stay 1 day.
Three deaths occurred within 30 days of
surgery, (0.05%). The most recent death
was 8 years ago

6. Results
• Early complications occurred in 4.9%.
• 44 (0.7%) patients had anastomotic leaks.
• Three (0.05%) patients presented with
dypepsia/bile reflux not responsive to
medical therapy and were successfully
treated by Braun side-to-side jejuno-
jejunostomy.
• Gastritis/dyspepsia/marginal ulcer was the
most serious long term complication;
routinely treated medically.

7. Results
• Excessive weight loss occurred in 1% of
patients; treated by take down of the
bypass.
• Mean % excess weight loss (EWL) of 78%.
10 year weight regain 4.9%.
• >50% EWL was achieved for 95% of
patients at 18 months and for 92% at 60
months.
• 6% of patient had inadequate weight loss
or significant weight regain were treated by
revision, (addition of ~2 meters to the
bypass).

8. Results Mirror Dr Noun’s
• One thousand consecutive mini-gastric
bypass: Noun R, et al. Journal Obes Surg. 2012 May;22(5):697-703
• Short-term complications occurred in 2.7% for
primary vs. 11.6% for revisionnal MGB (p < 0.01).
Five (0.5%) patients presented with leak
• Four (0.4%) patients, all with revisional MGB,
presented with severe bile reflux and were cured
by stapling the afferent loop and by a latero-lateral
jejunojejunostomy.
• Excessive weight loss occurred in four patients;
two were reversed and two were converted to
sleeve gastrectomy.
• Percent excess weight loss (EWL) of 72.5%

9. IFSO Varianational Committee Survey
Over 100 Surgeons from Around the World:

10. IFSO Varianational Committee Survey
• Results (Preliminary)
• Experience with 39,000 cases in the
prior year
• Lap Band is a "Poor" Surgery
• RNY & Sleeve Surgeons have "lots"
of leaks
• MGB Surgeons Answered More
Correct than Non-MGB Surgeons

11. MGB: Major Weight Loss, Best?

12. MGB: Least Weight Regain

13. MGB: Low Risk of Reflux Sx

14. MGB: Revision is Easy

15. Conclusion
• MGB is an
• effective,
• relatively low-risk, and
• low-failure bariatric procedure.
• In addition,
• it can be easily revised, converted, or
reversed.