Mini Gastric Bypass (MGB)
Mini gastric bypass surgery (MGB) is a laparoscopic weight loss surgery that can be revised. It is very similar to the traditional RNY bypass but only has one connection (single anastomosis) to the small intestine. Compared to gastric sleeve surgery and RNY, the MGB procedure is less invasive and requires less time for surgery and recovery. The complete procedure takes about 90 minutes or less and patient can be released from the hospital in 72 hours.
Instead of a small pouch like with the gastric sleeve, the mini gastric bypass surgery procedure creates a narrow tube-like pouch that holds approximately 1-2 ounces, restricting the amount of food that can be taken in at one time. The small intestine is then attached or looped to the new pouch approximately six to seven feet from its starting point. This placement bypasses the part of the intestines that allows for less nutrients, calories, and fats to be absorbed by the body, causing weight loss.
MGB is a mal-absorptive and restrictive procedure. Because you will eat less and absorb fewer calories, you will lose weight. Following surgery, and for the remainder of your life, it is important to take a bariatric multivitamin, calcium, vitamin B12, and iron (for women of menstruating age). With MGB, patients who employ proper nutrition, diet, and exercise can expect to lose up to 50% to 70% of their excess weight. They are also more likely to experience an overall well being and reduction of many co-morbidities associated with a person suffering from obesity.
Because this is a laparoscopic procedure, and no large incision is needed to perform mini gastric bypass surgery, there is a lower risk of large surgical scars or hernia. This procedure has a shorter operating time and less post-op complications reported.
Recent studies have shown that patients can expect to lose similarly to the traditional bypass, up to 50% to 70% of their excess weight by the end of the first year, and slightly more by the third year post-op. Usually the Mini Gastric Bypass is effective for people with a BMI of 35 and several co-morbidities.
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Benefits of Mini Gastric Bypass Procedure
- Weight loss
- Fast recovery time
- High percentage of success (up to 80%)
- Shorter operating times
- Technically easier
- Fewer complication rate than the traditional RNY bypass
- Less chance for dumping syndrome
- Reduction in co-morbidities such as hypertension, diabetes, high cholesterol, etc.
- Less re-routing of the intestines
The mini gastric bypass is a popular weight loss choice for those morbidly obese with a significant amount of weight to lose. With its high success rate, it is a great option to help shed unhealthy excess weight. The average weight loss for MGB is very similar to that of a regular RNY bypass. As with any weight loss surgery, the results will vary depending on the individual’s ability to make healthy lifestyle choices along with diet and exercise.
Mini Gastric Bypass Vitamin and Supplements Regimen
- Take a good bariatric multivitamin each day, such as: Optisource Post Bariatric Multivitamins, Opurity, Bariatric Fusion, Bariatric Advantage Multi Vitamin
- Calcium in the form of a chewable, preferably calcium citrate formula. Take 1500 mg of calcium citrate per day with Vitamin D 400 IU. Studies have shown that using calcium carbonate post-operatively can decrease the incidence of kidney stones.
- Vitamin B12 Sublingual: 5000–10,000 mcg per day or B12 injections from your primary care physician every month
- Biotin: 5000 mcg per day for the first year
- Probiotic (brand of your choosing)
- Iron (FeSo4): 18mg for men and non-menstruating women; 36 mg for menstruating women
Check your multi vitamins as it may have some of the iron and calcium already in them depending on the brand that you chose.
Risks of MGB Over Time
Gastric sleeve surgery can have some unwanted side effects that range from mild discomfort to those requiring another surgery. Gastric sleeve surgery is a relatively safe bariatric procedure that has become widely popular and accepted. One of the biggest advantages of the gastric sleeve surgery is that its expected weight loss is comparable to gastric bypass surgery, yet its relative risks are fewer than the RNY bypass.
Mild to Moderate Side Effects
Immediately after surgery, minor side effects such as pain from gas, bruising, bleeding, inflammation, and swelling are very common. For the vast majority of patients, these side effects and symptoms can be controlled with medication therapy, movement, and rest; these effects disappear within a day to several days following surgery.
Severe Side Effects
A few patients may suffer more severe complications, including: internal bleeding or leaking, gastritis (inflammation in the lining of the stomach), more than usual pain, and bloating in the abdominal area.
As with all surgeries, a very small number of patients may develop an infection, pneumonia, and nausea and/or vomiting. All severe side effects should be checked by a doctor without delay.
Blood clots, which can be fatal, occur in less than 1% of gastric sleeve patients (by comparison, it is estimated that 30–50% of knee and hip surgery patients develop blood clots).
What To Expect After Surgery
This surgery usually involves a two-to-three day stay in the hospital. Most people can return to their normal activities within three to five weeks. You will follow a liquid diet immediately after the MGB surgery. Your diet will progress to full liquids, pureed or blended foods, soft foods, and finally to a diet of solid foods.
Diet Following MGB
Your diet will be exactly the same as for the traditional RNY Bypass. See instructions below.
Phase 1 Dieting
After letting your new stomach heal, you will be able to sip clear liquids. Once you take clear liquids well (water; sugar-free Jello; broth; apple, grape, cranberry juices) then you will be able to move to the second stage of the mini gastric bypass diet.
Phase 2 Dieting
Since your stomach is smaller, you will start with small amounts of full liquids that will incorporate more nutrition. Full liquids include protein shakes, skim milk, Carnation Instant Breakfast, diluted oatmeal or instant potatoes, etc. You will be advised to eat or drink slowly, and in small quantities. You will start consuming two to four ounces per meal, then move up to four to six ounces per meal. In order to prevent dehydration, you will be advised to consume water and water-based liquids throughout the day.
Tip: One of the possible common side effects is dumping syndrome. One way to combat this is by avoiding foods and liquids that are high in fat, sugar, or contain alcohol.
Phase 3 Dieting
After sipping liquids all day, you will be relieved to find the next stage includes solid foods. You can begin adding soft cooked eggs, canned soft fruits, cottage cheese, canned chicken, and more. Your physician will likely instruct you to consume five or six small meals per day of about six ounces each. Eating and drinking slowly, you will take about 30 minutes to consume a meal. After your physician is satisfied with your progress you will move on. All foods need to be mushed or pureed at week three; the foods need to be the consistency of mashed potatoes.
Phase 4 Dieting
The last phase of the mini gastric bypass diet will include much-needed protein. You will be adding fish, chicken, turkey, beans, egg whites, etc. By adding these protein rich foods, you will help to heal after surgery and prevent hair loss. Hair loss is a common side effect and can be avoided by consuming more protein.
Tip: To speed up weight loss, it’s always advised to limit the amount of fat that you consume. Foods like mayonnaise, pastries, butter, peanut butter, fried foods of any kind, and potato chips all have excess fat that can slow your weight loss. Your goal is to consume enough fat to satisfy your nutrition without overdoing it; aim for no more than 40 grams per day.