The mini gastric bypass is a minimally invasive surgical procedure that is both restrictive and malabsorptive. It is also known as single anastomosis gastric bypass and is a simple operation that combines the characteristics of both gastric sleeve and Roux-en-Y Gastric Bypass. Apart from reducing the size of the stomach and restricting the amount of food eaten, this process also reduce the absorption of the food by bypassing approximately 6 feet of intestines.
How Mini Gastric Bypass is performed?
In this method the upper part of the stomach is split into a tube and then joined to a loop of small intestine. The stomach is divided with the help of a laparoscopic stapler such that a hockey-stick shaped sleeve along the lesser curve remains, while the baggy part is disconnected from the esophagus (food pipe). The native/remnant stomach henceforth will not receive food anymore (since the esophagus now leads to the new sleeve). Approximately 200 cm of the small bowel is bypassed. This means that this part of the small bowel will not come in contact with the food that comes down from the new stomach. The food directly enters the small bowel (jejunum) around 200 cm from its starting point, as this point is where the stomach and jejunum are connected together. The food therefore, runs into the new stomach and bypasses approximately 6 feet of intestine where it continues with the normal digestive process.
How does the Mini Gastric Bypass help in weight loss and diabetes control?
There are two ways by which the mini gastric bypass helps you in losing weight:
- The portion size is reduced like in a sleeve operation, as the new stomach has around 200-250 ml capacity.
- As a result of bypassing approximately 5 to 6 feet of the upper part of the small intestines, the amount of food absorbed is reduced.
Benefits of Mini Gastric Bypass:
The MGB is a powerful operation. It combines the power of the sleeve and the bypass together. In fact, it may be as powerful as the most potent bariatric procedure, the BPD (biliopancreatic diversion). The benefits of the MGB are:
- Patient can swallow food comfortably
- Patient can eat decent volumes
- No reflux or acidity symptoms (in vast majority)
- Stomach pouch does not dilate later in life, leading to weight gain
- Is reversible
- It is accumulating favorable reviews in scientific studies
- Patient satisfaction seems to be very high
- Pain scores and discharge times are the best amongst all procedures
- Virtually no leaks, compared to the sleeve and bypass.
- No internal hernias later
Is the MGB a better choice for me?
There is a very good chance that your answer is YES. In some situations, we would not consider the MGB. For example, in cirrhosis of liver, renal transplant recipients and in large, symptomatic hiatus hernias, the other procedures would get preference, not the MGB. Likewise, in the younger generation of patients, the MGB may not be the first choice.