Mini-Gastric Bypass Surgery in Tijuana, Mexico

INTRODUCTION

Mini Gastric Bypass Surgery

The One Anastomosis Gastric Bypass (OAGB), also known as “mini-gastric bypass” was first reported in 1997 and described in a paper by Dr. Robert Rutledge. The procedure has evolved as more surgeons developed it further.

How The Mini-Gastric Bypass Surgery Procedure Works

The mini gastric bypass is a minimally invasive laparoscopic procedure, similar to its counterpart, the Roux-en-Y gastric bypass. During a mini gastric bypass procedure, the surgeon first reduces the size of the “working” stomach by creating a pouch separate from the rest of the stomach. This tube-shaped gastric pouch is then connected (anastomosed) to the intestine, which results in up to 200cm of the upper part of the small intestine being bypassed.

It’s called a mini gastric bypass because, unlike its counterpart the Roux-en-Y gastric bypass (RYGB), it only requires a single connection to the small intestine instead of two. This results in a lower operation time (about 50 minute reduction in operation time), a quicker healing time, and a lower complication rate.

A OAGB procedure typically results in 30% to 40% total body weight loss from the patient’s starting weight (60-80% excess weight loss). The quickest weight loss occurs in the first 6 months post-op and then continues at a slower pace for up to another 18 months. Plateaus are normal and are usually overcome without much change to the diet.

 

This weight loss is achieved through both food quantity restriction and malabsorption. As a result of the procedure bypassing a part of the small intestine, the body is unable to absorb some of the calories from the consumed food. The substantial weight loss may lead to dramatic improvement, and even complete remission, of diseases such as high blood pressure, types 2 diabetes mellitus, and sleep apnea. According to a study done by Wang et al, the mini gastric bypass may result in slightly greater weight loss results and better resolution of diabetes than the RYGB.

The OAGB has few long term complications. Less than 5% of the patients may require revision surgery, with half of the revisional surgeries due to severe malnutrition and the other half due to bile reflux, ulcer and/or weight regain. However, there are potential downsides and risks.

  1. Fewer surgeons perform the mini gastric bypass, compared to the sleeve gastrectomy (gastric sleeve) and the Roux-en-Y gastric bypass.
  2. The bypass may lead to long-term vitamin/mineral deficiencies. Take care to watch out for deficiencies in vitamin B12, iron, calcium, and folate.
  3. Like all weight loss surgeries, the OAGB requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up compliance.

Advantages

Disadvantages