MGB - mini gastric bypass

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The "Mini" in the name of this procedure stands for the fact that it's almost always done laparoscopically.  The surgeon who did it for many years, was Dr Robert Rutledge, MD, a respected, skillful surgeon.  The MGB resembled the old "loop gastric bypass" or Billroth II.

The claim was that this procedure was safer than an RNY gastric bypass because it was possible that some of the pancreatic fluids and bile were channeled back into the pouch which, like the RNY, was made from the ring of muscle at the top of the stomach and if true, then, SOME digestion might take place in the stomach in MGB patients. Also in theory, the bile might neutralize the stomach acid so LESS acid gets into the small bowel which would be a good thing as stomach acid in the small bowel can cause damage.

The MGB bypasses 6 feet of small bowel so that's more than the usual gastric bypass bypasses.

The downside of having bile in the stomach was that about 25 percent of patients got bile reflux which while not dangerous was uncomfortable.  The surgeon claimed that most bile reflux stopped after a year.

A few years ago, the MGB got a very bad name when a patient started a vendetta toward the surgeon who pioneered the MGB.  The patient claimed (but could not prove)  horrific results from the procedure but it seemed that the vendetta may have had more to do with the surgeon not hiring this patient to work in his office than because the patient was as ill as claimed. And it seemed that the patient was most angry at not losing "enough" weight- fast enough- with the MGB, something which can happen with any gastric bypass.  This patient later got a revision to RNY and reached extremely slender size which was apparently the main plan in having Weight Loss surgery (the gastric bypass is not really recommended for looks but people do all sorts of things - it is a free country).  The surgeon sued the patient to stop their negative website on the MGB and won the suit - the website was taken down. This surgeon also claimed he ran a double blind study for two years,  proving the safety, and efficacy of the MGB over the RNY. 

However, there seemed little to no interest in other surgeons in switching to this procedure (favoring the RNY if they did gastric bypass) and since the surgeon who invented this flavor of gastric bypass may be in partial retirement, we don't hear much about the MGB lately. He still runs a "Boutique" practice in Las Vegas, NE.  The link below appears to be Dr Rutledge's current website.

Dr Rutledge and the MGB