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Major Meta Study: Mini Gastric Bypass as revision after Sleeve/Band is highly effective



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Guest

Yes, ladies and gentlemen, it's your local Mini Gastric Bypass fan again! Yay!

Someone asked the other day about MGB (also known as OAGB, Omega Loop, Single-Anastomosis Bypass) and I stumbled across this meta study.

  • 26 studies were included (aka huge sample)
  • Primary surgery was either version of the band or a sleeve gastrectomy (restrictive procedures)
  • Mean BMI at time of revision to Mini Gastric Bypass was 45.7
  • Mean BMI at Year 1 was 31.5
  • Mean BMI at Year 3 was 31.4
  • Mean BMI at Year 5 was 30.5

That's right - they lost on average 14.2 BMI points in the first 12 months and kept losing weight up to the 5 year mark.

So if you're considering revision, maybe give MGB a look? I love mine.

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On 3/4/2022 at 1:06 PM, GreenTealael said:

Hopefully surgeons can use this to lobby for insurance companies to begin covering the procedure.

Agree. It's truly ridiculous that the MGB/OAGB isn't considered a standard procedure in America. It's simpler, more effective, and has fewer side effects than most alternatives. It can be easily revised or reversed. People have a chance of keeping the weight off (no guarantees, of course).

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On 3/4/2022 at 4:01 PM, MiniGastricBypassDude said:

Agree. It's truly ridiculous that the MGB/OAGB isn't considered a standard procedure in America. It's simpler, more effective, and has fewer side effects than most alternatives. It can be easily revised or reversed. People have a chance of keeping the weight off (no guarantees, of course).

I’m sure it has something too do with the availability of surgeons trained in the procedure. Hopefully that changes soon.

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Yes, ladies and gentlemen, it's your local Mini Gastric Bypass fan again! Yay!
Someone asked the other day about MGB (also known as OAGB, Omega Loop, Single-Anastomosis Bypass) and I stumbled across this meta study.

  • 26 studies were included (aka huge sample)
  • Primary surgery was either version of the band or a sleeve gastrectomy (restrictive procedures)
  • Mean BMI at time of revision to Mini Gastric Bypass was 45.7
  • Mean BMI at Year 1 was 31.5
  • Mean BMI at Year 3 was 31.4
  • Mean BMI at Year 5 was 30.5
That's right - they lost on average 14.2 BMI points in the first 12 months and kept losing weight up to the 5 year mark.
So if you're considering revision, maybe give MGB a look? I love mine.
I am intrested in getting a revision from vsg to mgb. Do you get to choose how long the dr should make your bypass? How small do they make your stomach, the size of vsg stomach or the size of full gastric by pass?
Are you guys happy with the results? Do you get less hungry with the mgb as opposed to the vsg or lapband?

Sent from my SM-N950U using BariatricPal mobile app

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3 hours ago, Ninabnina77 said:

I am intrested in getting a revision from vsg to mgb. Do you get to choose how long the dr should make your bypass? How small do they make your stomach, the size of vsg stomach or the size of full gastric by pass?
Are you guys happy with the results? Do you get less hungry with the mgb as opposed to the vsg or lapband?

Sent from my SM-N950U using BariatricPal mobile app

Hi there - as I said in the reply in PMs, I thought I'd respond to these questions here so more people can hopefully benefit:

Quote

Do you get to choose how long the dr should make your bypass?

It's probably surgeon dependent. There's not a lot of evidence that a bypass > 150cm induces a lot more weight loss than one at the now-standard 150cm. There's a lot of evidence it increases the risk of nutritional issues, though, because the longer it gets, the closer you are to a DS-like malabsorption. So consider your needs.

Quote

How small do they make your stomach, the size of vsg stomach or the size of full gastric by pass?

The MGB is just a different bypass, not more or less full than RNY. The stomach is like a sleeve, but it's open in the end as opposed to the sleeve, meaning food passes through quickly. And that's the point of the surgery, to induce early satiety.

If you're looking for forced restriction, MGB isn't it. I can eat whatever I want in basically the quantities I want. I just ... don't want to eat a lot because I feel full and satisfied! fast. But then again, if you're looking for forced restriction, therapy is where you want to go. No surgery will fix an eating disorder.

Quote

Are you guys happy with the results?

Very.

Quote

Do you get less hungry with the mgb as opposed to the vsg or lapband?

Hunger comes back, and I obviously can't compare any of them on myself, but the idea of MGB isn't to eliminate hunger. It's to make you feel feel and satisfied really fast, so you'll eat less, you'll naturally want to eat a better diet, and you'll be happy with that.

Also, you asked somewhere else which surgeries had the most intestinal bypass. It goes like this:

Band/Sleeve: None -- RNY -- MGB -- DS, with the loop-DS and longer-bypass MGB being fairly close to each other.

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Hunger comes back, and I obviously can't compare any of them on myself, but the idea of MGB isn't to eliminate hunger. It's to make you feel feel and satisfied really fast, so you'll eat less, you'll naturally want to eat a better diet, and you'll be happy with that.
Also, you asked somewhere else which surgeries had the most intestinal bypass. It goes like this:
Band/Sleeve: None -- RNY -- MGB -- DS, with the loop-DS and longer-bypass MGB being fairly close to each other.
Wow, your so educated about bariatric procedures. I am so impressed. Thank you so much for taking the time to answer all my questions so thoroughly. I was under the impression the reason why the mini bypass was called mini when compared to the full bypass was because the mini had less intestinal bypass. So I guess was wrong and the by pass has more intestinal bypassing? When comparing the full to mini bypass, is the stomach made smaller in the full bypass? Would you say the full bypass has more restriction than the VSG? As I mentioned before, I have a life long problem with binge eating and I am always hungry. The VSG did minimal to help me in these two area, hence me looking into other surgical options. Right now my Dr. put me on contrave and it seems to be helping, but I don't want to be dependent on medication forever, I was hoping I could find a surgery that could provide me with a permanent fix. Btw, I am 5ft 7 inches tall, at my highest weight before the surgery I had gone up to 235 lbs. I had the VSG in June 2019. I managed to get down to 165 lbs, but took me teo years. Than I started gaining weight again I went up to 185 lbs. My dr has put me on contrave for the past 3 months and I have gone down to 170 lbs. I was neve able to reach my goal weight of 140 lbs. I live in fear of gaining all the weight back and having this vsg fully fail all the time. You look amazing, I wish I looked as good as you. [emoji1303]

Sent from my SM-N950U using BariatricPal mobile app

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2 hours ago, Ninabnina77 said:

Thank you so much for taking the time to answer all my questions so thoroughly.

No problem.

2 hours ago, Ninabnina77 said:

I was under the impression the reason why the mini bypass was called mini when compared to the full bypass was because the mini had less intestinal bypass.

It's called the mini because it's a simpler surgery than the roux-en-y bypass. There's nothing called the full bypass (I think the duodenal switch people would disagree with roux-en-y being a more full bypass than theirs, too). :)

2 hours ago, Ninabnina77 said:

When comparing the full to mini bypass, is the stomach made smaller in the full bypass?

Nope, MGB has a larger stomach and it's more open on the end, that's how it works: it delivers food to the small intestine really fast. This makes you feel satisfied very fast (but not stuffed) because the undigested food 'lands' further down the small intestine almost immediately. The body then says 'hold on, if we have this much undigested food all the way down here, better send signals we've had plenty of food'.

2 hours ago, Ninabnina77 said:

Would you say the full bypass has more restriction than the VSG?

Again, I assume you're referring to roux-en-y bypass, also called RNY or RYGB. I'm not the best to answer this; if I wanted restriction-only, I could've had my jaws wired shut, I guess? :D

2 hours ago, Ninabnina77 said:

As I mentioned before, I have a life long problem with binge eating and I am always hungry. The VSG did minimal to help me in these two area, hence me looking into other surgical options.

No surgery will fix the binge-eating hunger. (Group) therapy and hard and honest mental work will.

2 hours ago, Ninabnina77 said:

I live in fear of gaining all the weight back and having this vsg fully fail all the time.

I'd really look into other treatment options than surgery at this time, because it seems the issue is somewhere else?

3 hours ago, Ninabnina77 said:

You look amazing, I wish I looked as good as you.

Thank you, that's very kind. I wouldn't be a very good-looking woman :D

Best of luck!

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14 hours ago, Ninabnina77 said:

Would you say the full bypass has more restriction than the VSG? As I mentioned before, I have a life long problem

I can try to answer this since I have both.

No. Not for me.

It’s has been a completely different type of Satiation. VSG was an immediate forced hard stop because of pressure/tightening/pain where you might still feel hungry or wish you could eat more but physically cannot.

With RNY there is the feeling of disinterest or boredom with eating. I *could* eat more but I don’t want more. And I feel full lower in the abdomen vs higher in the chest (VSG).

If you are chasing restriction, you may be disappointed. But this is only my experience. Ask around to those that had both procedures to gather more opinions. I hope that helps.

Edited by GreenTealael

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What is the difference between the MGB and a "regular" bypass? I've never heard of the mini before.

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On 3/28/2022 at 10:55 AM, Guest said:

Hi there - as I said in the reply in PMs, I thought I'd respond to these questions here so more people can hopefully benefit:

It's probably surgeon dependent. There's not a lot of evidence that a bypass > 150cm induces a lot more weight loss than one at the now-standard 150cm. There's a lot of evidence it increases the risk of nutritional issues, though, because the longer it gets, the closer you are to a DS-like malabsorption. So consider your needs.

The MGB is just a different bypass, not more or less full than RNY. The stomach is like a sleeve, but it's open in the end as opposed to the sleeve, meaning food passes through quickly. And that's the point of the surgery, to induce early satiety.

If you're looking for forced restriction, MGB isn't it. I can eat whatever I want in basically the quantities I want. I just ... don't want to eat a lot because I feel full and satisfied! fast. But then again, if you're looking for forced restriction, therapy is where you want to go. No surgery will fix an eating disorder. There are a couple of essays about this at https://gradesfixer.com/free-essay-examples/eating-disorders/ where this topic is better covered. 

Very.

Hunger comes back, and I obviously can't compare any of them on myself, but the idea of MGB isn't to eliminate hunger. It's to make you feel feel and satisfied really fast, so you'll eat less, you'll naturally want to eat a better diet, and you'll be happy with that.

Also, you asked somewhere else which surgeries had the most intestinal bypass. It goes like this:

Band/Sleeve: None -- RNY -- MGB -- DS, with the loop-DS and longer-bypass MGB being fairly close to each other.

Thanks for the answers, I feel a little more clear on this subject now.

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