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One Year With Mini Gastric Bypass: My Journey, Thoughts, and Tips!

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On 12/7/2021 at 12:37 AM, Guest said:

The surgery: what is it, how does it work, what does science say about weight loss and complications with MGB?

What is it?
There’s nothing ‘mini’ about the MGB. The name was given by Dr. Rutledge who invented it in 1997 to describe its simpler configuration compared to Roux-en-Y gastric bypass.

Basically, the stomach is divided and a long, narrow pouch is created (a little like the sleeve), but the rest of the stomach is left in place (like with RNY). A loop of the small intestine is then connected to the pouch, and that’s it.

There’s one connection point – one anastomosis – and unlike the sleeve, the food travels directly down into the intestine, as the pyloric valve is bypassed. The bypass is anywhere from 150cm – 350cm (3 to 9 feet), though recently most surgeons do 150cm to avoid malnutrition later on.

Here’s a diagram:


How does it work?
As with all bariatric surgery, there are things we know and things we don’t know. We obviously feel full faster due to the smaller stomach, but because it’s ‘open’ in the bottom to the intestine, and this anastomosis is not especially narrow, we can usually eat pretty large amounts fairly soon after surgery.

My personal experience is that I’ve only felt I ‘had no more room’ a few times, and always with minced meat, weirdly enough.

The big trick is that you feel satisfied very quickly, because the food lands undigested pretty far down the intestine. It’s like the feeling after a huge Christmas dinner. Technically, I could eat more, but I feel stuffed (and satisfied). So I don’t.

We have at least 3-4x the malabsorption of RNY, so there’s some calories being flushed right out. Personally, I can see when I eat a higher-fat meal that some of it goes through undigested (sorry for theTMI).

How much do you lose?
Unlike what people think, there are tons of studies out there documenting that weight loss is generally greater after MGB than after sleeve and RNY. Not a single study out there shows less weight loss with MGB when comparing MGB and RNY.

Excess Weight Loss (EWL) ranges from mid-60s % EWL to the 80s after one year (a few studies show even higher WL, but those are generally from cohorts of fairly low-BMI study populations).

All-in-all, weight loss is excellent and looks like it’s long-term durable in the studies. Especially when compared to the sleeve.

For some reason, there’s a ‘feeling’ among American bariatric surgeons that MGB carries a higher risk of stomach cancer. This is not true, and it has been studied. A few patients experience bile reflux, but this is a lesser concern with the Spanish ‘anti-reflux stitch’ most MGB surgeons now use. Mine did as well, and while I suffered heavily from GERD prior to surgery, this is no longer a problem.

Long-term, malnutrition is an issue, so take your Vitamins. Think of Vitamins as being generally a good idea for sleevers, mandatory in the beginning for RNY’ers and then see how your labs develop as the years pass, to very important for MGB, also long-term, and life-or-death for our duodenal switch friends. This reflects the malabsorption – none in sleeve, a little in RNY, a moderate-to-significant amount in MGB, and a lot in DS.

Thanks for the elaborating the entire journey! A big massive congratulations on your success that has been inspiring... That was a brilliant read and it mirrored my journey too to a large extent. I'm now 6 months post op and I have lost about 29kg or 64lbs in total. I feel like a different person altogether! I have more energy and my knee pain is virtually nonexistent. I have another 36lbs to go and I'm not bothered about how soon this happens or it happens at all! I chose mini gastric bypass for the same reason that you mentioned and I have no food intolerances or dumping. I don't get these contemptuous looks when I go to the gym or a yoga class anymore... I'm not self conscious when I go clothes shopping either. I don't really feel like I've had a surgery on many occasions as I have had little or no issues post op.

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