- The MiniGastric Bypass (MGB) is a short, simple, successful and inexpensive laparoscopic gastric bypass weight loss surgery. The operation usually takes only 30 min., hospitalization less than 24 hours.  The Mini Gastric Bypass is low risk, has excellent long term weight loss, minimal pain and can be easily reversed or revised. People from all across America and around the world are choosing the MGB as the Best in Bariatric Surgery.

- Recent MGB Patient Experiences: 1-"2 years and 135 pounds later," 2-"This was by far the best thing I have ever done," 3-"I walked a 5K 9 days post-op"

- Dr. Rutledge presenting MGB research in Holland 10th World Congress of the International Federation for the Surgery of Obesity 19th International Symposium on Obesity Surgery August 31st - September 3rd 2005 Maastricht, the Netherlands

- Two New Mini-Gastric Bypass programs bow in!  Texas and Costa Rica have just become the newest members of the growing MGB family!  From more info on Houston Texas please call Dr. Peraglie at 713-582-9589 or email him at DrP@clos.net.  For more info on 1:Costa Rica, 2: "The new Cosmetic" gastroplasty or 3: Medicare or Tricare insurance call Dr. Rutledge 702-215-9550.

- Listen To Dr. Rutledge and MGB patients on the radio now!  Dr. Rutledge was interviewed on "Lighten Up America." Hear about the Mini-Gastric Bypass and weight loss surgery in general. Also, many of his patients were interviewed about their surgical weight loss journey.  Listen to these radio shows right now, click here.

- Good News, The MGB gets its own Billing code.  New 2005 CPT codes have added 43645-Laparoscopy, surgical, gastric restrictive procedure; with gastric bypass and small intestine reconstruction to limit absorption. 43644 is the code for Lap RNY gastric bypass.

Surgery Overview 

Gastric bypass surgery makes the stomach smaller and allows food to bypass part of the small intestine. You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus calories consumed. Bypassing part of the intestine results in fewer calories being absorbed. This leads to weight loss.

The most common gastric bypass surgery is a Roux-en-Y gastric bypass. 

In normal digestion, food passes through the stomach and enters the small intestine, where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted.

In a Roux-en-Y gastric bypass, the stomach is made smaller by creating a small pouch at the top of the stomach with surgical staples or a plastic band. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum). 

This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach).

See an illustration of a Roux-en-Y gastric bypass.

What To Expect After Surgery 

This surgery usually involves a 4- to 6-day hospital stay (2 to 3 days for a laparoscopic approach). Most people can return to their normal activities within 3 to 5 weeks. 

Gastric bypass surgeries may cause dumping syndrome. This occurs when food moves too quickly through the stomach and intestines. It causes nausea, weakness, sweating, faintness, and possibly diarrhea soon after eating. These symptoms are made worse by eating highly refined, high-calorie foods (like sweets). In some cases you may become so weak that you have to lie down until the symptoms pass.

Why It Is Done 

Gastric bypass surgery is rarely used to treat obesity. Many health professionals will consider it only for people who have not been able to lose weight with other treatments and who are at high risk for developing other health problems because of their weight.

Although guidelines vary, surgery is generally considered when your body mass index is 40 or higher or you have a life-threatening or disabling condition related to your weight.

The following conditions may also be required, or are at least considered: 

Have been obese for at least 5 years 
Not have a history of alcohol abuse 
Not have depression or another major psychiatric disorder 
Be between 18 and 65 years of age 
All surgeries have risk, and it is important for you and your health professional to discuss your treatment options to decide what is best for your situation.

How Well It Works 

Most people who have open gastric bypass surgery quickly begin to lose weight and continue to lose weight for up to 12 months. One study noted that people lost about one-third of their excess weight (the weight above what is considered healthy) in 1 to 4 years.1 Some of the lost weight may be regained.

The laparoscopic approach showed similar results, with 69% to 82% of excess weight lost over 12 to 54 months.2 At this time, the laparoscopic approach for gastric bypass has not been used long enough to draw significant conclusions about how well it works.

Risks 

Risks common to all surgeries for weight loss include an infection in the incision, a leak from the stomach into the abdominal cavity or where the intestine is connected (resulting in peritonitis), and a blockage of blood flow within the lung (pulmonary embolism). About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia and osteoporosis.3, 4

Fewer than 3 in 200 (1.5%) people die after surgery for weight loss.3

After a Roux-en-Y gastric bypass:5, 3

An iron and vitamin B12 deficiency occurs more than 30% of the time. About 50% of those with an iron deficiency develop anemia. 
The connection between the stomach and the intestines narrows (stomal stenosis) 5% to 15% of the time, leading to nausea and vomiting after eating. 
Ulcers develop 5% to 15% of the time. 
The staples may pull loose. 
Hernia may develop. 
The bypassed stomach may enlarge, resulting in hiccups and bloating. 
What To Think About 

In a gastric bypass, the part of the intestine where many minerals and vitamins are most easily absorbed is bypassed. Because of this, you may have a deficiency in iron, calcium, magnesium, or vitamins. This can lead to long-term problems, such as osteoporosis. To prevent vitamin and mineral deficiencies, you may need to work with a dietitian to plan meals and may need to take nutrient supplements and injections of vitamin B12.

Early studies of the laparoscopic approach to surgery for obesity suggest that it reduces recovery time and postsurgery complications.2 A laparoscopic approach for this surgery has not been used long enough to draw significant conclusions.

Complete the surgery information form to help you prepare for this surgery. 

References 

Citations
Balsiger BM, et al. (2000). Prospective evaluation of Roux-en-Y gastric bypass surgery as primary operation for medically complicated obesity. Mayo Clinic Proceedings, 75: 673–680.

Schauer PR, Ikramuddin S (2001). Laproscopic surgery for morbid obesity. Surgical Clinics of North America, 81(5): 1145–1179.

American Gastroenterological Association (2002). AGA technical review on obesity. Gastroenterology, 123(3): 882–932.

National Institute of Diabetes and Digestive and Kidney Diseases (2001). Gastrointestinal Surgery for Severe Obesity (NIH Publication No. 01–4006). Available online: http://www.niddk.nih.gov/health/nutrit/pubs/gastric/gastricsurgery.htm.

Brolin RE (2002). Bariatric surgery and long-term control of morbid obesity. JAMA, 288(22): 2793–2796.

Credits 
Author  Paul Lehnert 
Editor  Susan Van Houten, RN, BSN, MBA 
Associate Editor  Tracy Landauer 
Primary Medical Reviewer  Caroline S. Rhoads, MD

- Internal Medicine 
Specialist Medical Reviewer  W. Stewart Agras, MD

- Psychiatry 
Last Updated  October 9, 2003 

- We're #1, the Best Gastric Bypass web site on the internet. Google,  MSN.com and AOL.com rank CLOS.Net and the Mini-Gastric Bypass as the #1 web site on the internet for gastric bypass.Google, the #1 internet search engine ranks clos.net #1 out of about 602,000 gastric bypass web sties.  (CLOS.net is also in the top 10 best web sites on Lycos.com, Teoma.com, Vivísimo.com, Ask Jeeves and on Yahoo.com out millions of web pages!)

- MGB Hospital continues Success in Las Vegas, Nevada: 86 MGB's finished successfully at our new MGB hospital in Las Vegas.  Operating times 20-60 min surgery, 24 hr Hospital stay! Call to schedule cases or for more information. Dr. Rutledge's private Cell Phone: 702-215-9550, CLOS West: Office 702-456-4643, Trish Lanman 702-376-3446, Sandy Brubaker 702-376-3647, Email: Dr. Rutledge DrR@clos.net,  Trish Lanman PEL@clos.net, Sandy Brubaker SandyB@clos.net

- New Videos of a Patient Interview, the MGB Surgery and of an MGB Revision  Now in higher quality video for broadband.

- Costs: According to a recent USA Today article "Weighing the cost of obesity" weight loss surgery usually costs about $24,000. In contrast the total cost for the MGB is $17,000. (Note: For patients that cannot afford the MGB and their insurance will only cover the Roux-en-Y gastric bypass, CLOS will be offering a Mini-Roux-en-Y and accepting insurance coverage for the hospital and anesthesia portions of the surgery.)

- Now get the Free Book on Obesity and Weight Loss Surgery: Get the latest update on Obesity and Weight Loss Surgery in America.  You can read about the latest results of different types of surgery as well as updates on diet exercise and drug therapy.

- Join Us!  Join the thousands of other successful "MGB" patients that have lost weight after the 30-60 minute Mini-Gastric Bypass surgery with an overnight hospital stay.  Email and talk directly with thousands of people just like you.

- New study shows Atkins, Weight Watchers, Zone and Ornish diets all fail to produce significant weight loss.

- MGB now available around the U.S.: Texas, North Carolina, Nevada, Michigan, Missouri and Florida all have strong growing MGB programs associated with CLOS. Great News! Our Newest Center to open April 25th in Houston Texas! For more information or to schedule surgery please contact: Catherine LeRoy at 704-871-0031 or 704-682-8009, e mail clr@clos.net , Star Sweet at 417-291-2892, e mail stars@clos.net, Elizabeth Robbins, 989-415-0238, e mail epr@clos.net , Dr Cesare Peraglie 702-376-9339, e mail drp@clos.net See the newest Houston facility: http://www.springbranchmedical.com

- New MGB Program to open with Dr. Rutledge in San Jose Costa Rica!  We will be offering the "Cosmetic" Mini-Banded Gastroplasty for obese people who are not morbidly obese.  We have just competed our review of the hospital facilities and are nearing start up.   Please email or call us for more information: Phone Dr. Rutledge Cell Phone: 702-215-9550, CLOS West: Office 702-456-4643, Dr Rutledge (Cell Phone) 702-215-9550, Trish Lanman 702-376-3446, Sandy Brubaker 702-376-3647, Dr. Peraglie: 702-376-9339, Email: Dr. Rutledge DrR@clos.net,  Trish Lanman PEL@clos.net, Sandy Brubaker SandyB@clos.net

- Listen To Dr. Rutledge on the radio now! Recently, Dr. Robert Rutledge was interviewed on Lighten Up America, a radio show dedicated to educating people about obesity surgery. (You need the Flash Player to listen.) 

- Spanish Study Confirms Excellent Results with Mini-Gastric Bypass Dr. Rutledge's Mini-Gastric Bypass surgery is shown to be a simple low risk with excellent outcomes.  Endoscopy shows no evidence of bile reflux.

- View Dr Rutledge's presentations for the 9th World Congress of IFSO: 6 Year Study of the MGB,  Elimination of the Learning Curve in the Mini-Gastric Bypass

- Read and view a description of the MGB Surgery Watch and read about the short simple Mini-Gastric Bypass.

- New Study shows that 39% of RNY Gastric Bypasses Back in Hospital for Complications: Pennsylvania study reports that Roux-en-Y gastric bypass surgery has a 39% rate of readmissions for conditions related to this Non-MGB gastric bypass. Pennsylvania Costs for surgery twice as high as MGB.

- New Study Recommends MGB as Best Choice as Salvage for Failed VBG (Vertical Banded Gastroplasty)

- Mini-Gastric Bypass is being adopted around the world.  Dr Rutledge recently spoke at the 9th World Congress of the International Federation for the Surgery of Obesity  September 8 - 11, 2004 in Tokyo, Japan  http://www.pac.ne.jp/ifso and will be speaking Spain.  View Dr. Rutledge's MGB presentations in Japan (1, 2)Now surgeons in Canada, Mexico, Spain, Brazil, Romania, Taiwan and Australia are all adopting the Mini-Gastric Bypass!  Surgeon reports first successful MGB in Mexico.  New surgeon from Romania reports excellent results with MGB!

- Canadian Health Service approving some patients for MGB!  Over 221 patients turned out for recent informational seminar in Toronto Canada. Dozens of Canadians have had the MGB.  For Canadians click here...

- MGB now Success in Florida "I had my surgery on June 16 in Davenport, FL.  My procedure was 62 minutes. I had some pain and nausea when I first got out of surgery, but everyone at the hospital worked quickly and the relief was very fast. I was up and walking around later that afternoon. I had my gall bladder out in 1993 and the MGB was SO much easier on me then that was. For anyone who is planning on surgery in Florida, I have to say I couldn't have had a better experience."  “The procedure itself is done in about 30 to 60 minutes, what’s more, recovery is exceptionally fast. Only a 24-hour hospital stay is necessary, and within a few hours after surgery, patients are up and walking around. Plus, patients are able to resume their normal, day-to-day activities in just a few days.”

- CLOS-High Point North Carolina! Dr's Dasher and Walsh are having clinics on Mondays and Wednesdays at The Millis Rehabilitation Center at 4p.m at High Point Regional Hospital. High Point Regional Hospital is right off Highway 311, at 601 N. Elm Street, High Point NC. 336-878-6000. 

- New Independent Controlled Prospective Randomized Study confirms Dr Rutledge's MGB outperforms RNY gastric bypass.  In a randomized head to head comparison the MGB had shorter operative times, fewer complications and weight loss as good or better than the RNY gastric bypass.

- Exciting 5 year Follow Up Results!  New follow up data shows continued excellent long term weight loss and low complication rates in MGB patients. (See it in 3D!)

- Short, Simple, Effective Surgery "Imagine, my surgery took only 18 minutes, (Our 2,000th case took only 15 min.)  I had no pain, was up and out of bed walking two hours after surgery and was out of the hospital less than 24 hours later!"  Our 2,000th patient, Susan B's surgery took only 15 minutes!  Read What Hundreds and Hundreds of Patients say about their MGB!Read one patient's Weight Loss Surgery Success and another and another and another!

- Please Call Us Anytime for Help or Questions :Call Us for Help Anytime: Dr. Rutledge' Personal Cell Phone: 702-215-9550, ****CLOS West (Nevada, California and Costa Rica): Office 702-456-4643, Dr Rutledge (Cell Phone) 702-215-9550, Trish Lanman 702-376-3446, Sandy Brubaker 702-376-3647, Veronica Gonzalez 702-400-8636, Dr. Peraglie: 702-376-9339 ****CLOS North Carolina: Debra Green 336-906-2810, 336-841-0326 office, Surgeons Dr. James Dasher and Dr. Tom Walsh, 336-841-0326, **** CLOS Missouri Office: 417-206-2596 office, Star Sweet 417- 291-2892, Dr David Hargroder, 417-483-7090 ****CLOS-Michigan: Kim Hazen 989-450-8081, Dr. Paul Doroghazi, 989-892-4591, ****CLOS Florida Wayne Robbins 704-682-1549 ****CLOS Texas: Catherine LeRoy 704-682-8009, Elizabeth Robbins 989-415-0238, Dr. Cesare Peraglie: 713-582-9589 ****Our Nurse Debbie Pennell 704-682-2145 *****CLOS ADMINISTRATIVE OFFICES: 704-871-0031 Main office, Elizabeth Robbins 989-415-0238, Brian Chu 417-291-1018, Nancy Monroe 704-682-0260, Catherine LeRoy 704-682-8009, Wayne Robbins 704-682-1549 .

- Dr. Kurt Semm, surgery pioneer, dies in Tucson Dr. Kurt Semm, whose pioneering techniques in minimally invasive surgery were initially ridiculed but led to innovations in many types of operations, died July 16 at his home.  Surgeons and other Doctors are slow to recognize new techniques.

- Resolution of Diabetes The Mini Gastric Bypass is a low risk, short, simple and effective treatment of Type II Diabetes Mellitus.  Over 82% of Diabetics resolve their Diabetes completely following the MGB.  "I am very pleased with my MGB results.  I fit into a size 8 now and my health has improved significantly. All of my blood work is done on regular basis and has been wonderful. My cholesterol was 240 pre-op with meds, now its 127!  My Diabetes is gone, my HgbA1c was 7.5 pre-op now it is 4.2 with no meds!!"

- Study shows Mini Gastric Bypass patients have shorter operating times, a shorter hospital stay and lower rates of wound infection, hernia and leak than a comparable series of Lap RNY patients.

- Ghrelin is a hormone made in the stomach stimulates food intake. A new study shows dieting increases Ghrelin (makes you hungrier) while Gastric Bypasssuppresses Ghrelin, explaining some of it’s effectiveness.

- Dr. Rutledge is the most highly recommended weight loss surgeon on the independent, nationally recognized ObesityHelp.com web site. Click here to see what hundreds of people say about the MGB and Dr. Rutledge.

- Patient Emails: "I have gone from a size 26/28 to a 6!!"  Join our online mailing list and chat with hundreds of pre and post op patients...

- Costs: According to a recent USA Today article "Weighing the cost of obesity" weight loss surgery usually costs about $24,000.  In contrast the total cost for the MGB is $17,000.

- NEW Version! Online Manual for information and guidance on having Weight Loss Surgery.

- Watch the MGB Movie (Get free RealPlayer.)

- The Four Stages of Scientific Acceptance famous geneticist J.B.S. Haldane said... "1-This is worthless nonsense. 2-This is an interesting, but perverse point of view. 3-This is true, but quite unimportant. 4-I always said so." 

- Excellent results of the MGBconfirmed by two independent studies,an unprejudicedCertified Public Accounting firm confirms excellent results for the Mini-Gastric Bypass.