Mini-gastric bypass (MGB) has been shown to be a valuable addition to the armamentarium of bariatric surgery.
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MGB has been a low risk surgery, which has a durable weight loss with a high level of patient satisfaction.
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It has a short learning curve but new surgeons should be aware of tricks and traps of this operation to avoid complications.
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In addition, MGB is simple to reverse or revise.
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The misunderstood of MGB procedure's technical details can led to complications and even cause death.
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By following Dr Rutledge’s MGB technique, new surgeons can protect patients from both minor and severe complications.
Abstract
Introduction
Mini-Gastric Bypass (MGB) is becoming more and more popular as shown by the numerous articles published over the past 15 years, supporting the operation as a short and simple procedure with excellent outcomes and low complication rates. There is still confusion amongst surgeons on the technique of the operation. The purpose of this paper is to review and describe the technique of MGB by its originators.
Methods
With 20 years of experience of performing the original MGB, the authors present the details of the MGB.
Results
The MGB consists of a long conduit from below the crow's foot extending up to the left of the angle of His. It is similar to, but importantly, not the same as the pouch of the Sleeve Gastrectomy. MGB has a wide gastro-jejunal anastomosis to an anti-colic loop of jejunum 150–200 cm distal to the ligament of Trietz. The power of MGB comes from the fact that it is both a “Non-Obstructive” restrictive procedure and it also has a significant fatty food intolerance component with minimal malabsorption.
Conclusion
In this article we describe the original Rutledge technique of Mini-Gastric Bypass. Notably this is neither a “Single Anastomosis bypass”, nor an “Omega Loop Bypass” and also not the “One Anastomosis Bypass of Carbajo”. It is a particular technique first created by Rutledge in 1997 and associated with low risk and excellent outcomes. The goal of this manuscript is to help avoid complications and problems seen when the operation deviates from some of the basic principles of general surgery used in the original operation.