mini gastric bypass

[Guest guest]

I am still researing surgery. I had pretty much decided that the

mini gastric bypass was the one i wanted. One because it was a lap

and two its the closes doctor in our state. I was under the

inpression that a " MINI " was called a mini because it was a lap and

not an open.. I found this information, on another site, and now know

that mini is not short for 'lap'. I would like some feedback on

the 'mini' especially from the doctor, if possible. about this......

thanks

Loop Gastric Bypass ( " Mini Gastric Bypass " )

This form of Gastric Bypass was developed years ago, and has

generally been abandoned by nearly all bariatric surgeons as unsafe --

several years ago, a consensus of the American Society for Bariatric

Surgery was that the procedure should never be performed.

Although easier to perform than the Roux en-Y, it creates a severe

hazard in the event of any leakage after surgery, and seriously

increases the risk of ulcer formation, and irritation of the stomach

pouch by bile. Many persons who underwent this procedure in the past

have required major revisional operations to correct severe

discomfort and life-threatening pathophysiologic effects. Most

bariatric surgeons agree that this operation is obsolete, and should

remain defunct.

This operation has been resurrected, in order to make the

laparoscopic procedure easier to perform, by possibly less skilled

surgeons. As shown, the gastric pouch is excessively large, which

may lead to loss of weight control over time.

A fundamental principle of laparoscopic surgery is that the

underlying operation should not be compromised or degraded, in order

to accomplish it by using limited access techniques. The loop bypass

does not meet this standard. There is no reliable long-term data to

support use of this anatomic variation.

Gastroplasty (Stomach Stapling, Gastric Stapling)

We mention this operation for completeness, although we do not offer

it, because we do not believe in it, as an effective treatment.

Gastroplasty, or Stomach Stapling (Gastric Partitioning) is widely

performed in the United States and elsewhere. It is a technically

simple operation, accomplished by stapling the upper stomach, to

create a small pouch, about the size of your thumb, into which food

flows after it is swallowed. The outlet of this pouch is restricted

by a band of synthetic mesh, which slows its emptying, so that the

person having it feels full after only a few bites (one thumbful) of

food. Characteristically, this feeling of fullness is not associated

with a feeling of satisfaction - the feeling one has had enough to

eat.

Patients who have this procedure, because they seldom experience any

satisfaction from eating, tend to seek ways to get around the

operation. Trying to eat more causes vomiting, which can tear out

the staple line and destroy the operation. Some people discover that

eating junk food, or eating all day long by " grazing " helps them to

feel more sense of satisfaction and fulfillment -- but weight loss is

defeated. In a sense, the operation tends to encourage behavior

which defeats its objective.

Overall, about 40% of persons who have this operation never achieve

loss of more than half of their excess body weight. In the long run,

five or more years after surgery, only about 30% of patients have

maintained a successful weight loss. Many patients must undergo

another, revisional operation, to obtain the results they seek.

Because of the poor reported results with this surgery, we do not

recommend or offer it - we can achieve far better results, with no

increased risk, or increased expense. When revision of a

Gastroplasty is necessary, we recommend conversion to a Gastric

Bypass.

[Guest guest]

,

Thank you so much for such an informative post. I've attempted to explain to

my husband why I wanted Dr R's procedure. Your post puts it in language he

can understand.

Thanks

(from a lurker) Janice

[Guest guest]

> I am still researing surgery. I had pretty much decided that the

> mini gastric bypass was the one i wanted. One because it was a lap

> and two its the closes doctor in our state. I was under the

> inpression that a " MINI " was called a mini because it was a lap and

> not an open.. I found this information, on another site, and now

know

> that mini is not short for 'lap'. I would like some feedback on

> the 'mini' especially from the doctor, if possible. about this......

>

> thanks

The doctors who have posted this on their page are posting false

information and deliberately confusing terms in order to conduct what

is transparently an assault on Dr. Rutledge's procedure.

They have a money-making cash-cow in their mass-production/celebrity

endorsed facility that performs the RNY and they do NOT want to be

forced to admit that their procedure is not only inferior, it is

dangerous, relative to the new standard now firmly established by Dr.

Rutledge.

If their patients find out the truth, they could be getting sued for

malpractice for *not* using the safest and most easily performed

procedure. Now, you might begin to get an idea of why they are

trying

so hard to bad-mouth a procedure that makes *them* look really bad.

First, go to:

http://www.clos.net/mgb-paper/MGB-Paper061300.htm

There you can read Dr. Rutledge's complete data on 657 patients on

whom he has performed the MGB.

You will find that the incidence of ulceration is far *LOWER* than

the

incidence of ulceration for either the lap or open RNY. In fact,

you'll find that the incidence of complications, overall, is *LOWER*

than for either the lap or open RNY. You'll also find that weight

loss is *greater.* It is also about 1/3 the cost of the open RNY and

less than half the cost of the lap RNY.

You'll also find the time in surgery for the MGB is about 35 minutes,

whereas the time in surgery (and therefore, under anaesthesia which

presents one of the greatest risks of complications and death in any

surgery) is far longer for the open RNY (about 4-7 HOURS) and the lap

RNY (2-4 HOURS).

You'll also find that there is virtually *no* risk of incisional

leaks

or hernias with the MGB, whereas this is a regular complication of

the

open RNY, which also leaves patients with a huge abdominal scar and

internal adhesions for the rest of their lives.

You'll also discover that patients feel *GOOD* not just " okay, " or in

" bearable pain " the SAME OR NEXT DAY after the MGB.

I've had the MGB and I literally ran down the hallway the day after

my

surgery (no pain, feeling fine!!) to catch Dr. R and ask him a

question.

Recovery time after the RNY? Just ask any patient -- anywhere from 2

- 8 WEEKS.

As for the ability to reverse the procedure, the MGB is reversible

laparoscopically in one hour. Dr. Rutledge will show you this on

video at the first clinic you attend.

The RNY is *not* easily reversible and reversals have a much higher

complication rate than the original procedure. The RNY causes more

extensive changes to the gastro-intestinal system, requires a much

more dangerous operation initially (involving surgery beneath the

liver and up into the esophogeal area, and near the aorta, so it is

inherently more dangerous to begin with) and leaves the patient with

much more extensive adhesions which will complicate a later

procedure.

A subsequent reversal will also involve the same more dangerous

surgery into the area near the aorta.

Patients are also more likely to get blood clots (and stroke or

heart attack) after the RNY because they are not up and around

immediately after surgery, like MGB patients and statistics bear this

out, too (reported on the page I cited you, above).

The MGB is superior in every respect to the RNY. There are *no*

statistics that support the slop that was on that page you quoted

(and

you'll note they didn't bother to provide any references or sources

for their claims. Why? Because they are pure fantasy.)

Before my surgery, I interviewed 89 (now 97) of Dr. Rutledge's

patients, some with complications, and can tell you that the

information I found supported Dr. Rutledge's own statistics.

My own experience with the MGB likewise has borne that out, too. I

was in surgery 37 minutes, I was up and around as soon as I woke up

from surgery. I was walking the hallways in *NO* pain that evening.

I left the next day, went shopping at the mall, went to a support

group meeting, drove my renta-car, went to the mall a couple of more

times, hoisted an 80 pound suitcase into the renta-car and shlepped

it

around the airport, walked about a mile or more in the Memphis

airport

to change planes, then met a friend to go to Florida for three days.

That is the sum of my first five days POST OP. And I am *not* the

exception, I'm the norm.

>

> Loop Gastric Bypass ( " Mini Gastric Bypass " )

>

> This form of Gastric Bypass was developed years ago, and has

> generally been abandoned by nearly all bariatric surgeons as unsafe

--

> several years ago, a consensus of the American Society for

Bariatric

> Surgery was that the procedure should never be performed.

>

> Although easier to perform than the Roux en-Y, it creates a severe

> hazard in the event of any leakage after surgery, and seriously

> increases the risk of ulcer formation, and irritation of the

stomach

> pouch by bile. Many persons who underwent this procedure in the

past

> have required major revisional operations to correct severe

> discomfort and life-threatening pathophysiologic effects. Most

> bariatric surgeons agree that this operation is obsolete, and

should

> remain defunct.

>

> This operation has been resurrected, in order to make the

> laparoscopic procedure easier to perform, by possibly less skilled

> surgeons. As shown, the gastric pouch is excessively large, which

> may lead to loss of weight control over time.

>

> A fundamental principle of laparoscopic surgery is that the

> underlying operation should not be compromised or degraded, in

order

> to accomplish it by using limited access techniques. The loop

bypass

> does not meet this standard. There is no reliable long-term data

to

> support use of this anatomic variation.

>

> Gastroplasty (Stomach Stapling, Gastric Stapling)

>

> We mention this operation for completeness, although we do not

offer

> it, because we do not believe in it, as an effective treatment.

>

> Gastroplasty, or Stomach Stapling (Gastric Partitioning) is widely

> performed in the United States and elsewhere. It is a technically

> simple operation, accomplished by stapling the upper stomach, to

> create a small pouch, about the size of your thumb, into which food

> flows after it is swallowed. The outlet of this pouch is restricted

> by a band of synthetic mesh, which slows its emptying, so that the

> person having it feels full after only a few bites (one thumbful)

of

> food. Characteristically, this feeling of fullness is not

associated

> with a feeling of satisfaction - the feeling one has had enough to

> eat.

>

> Patients who have this procedure, because they seldom experience

any

> satisfaction from eating, tend to seek ways to get around the

> operation. Trying to eat more causes vomiting, which can tear out

> the staple line and destroy the operation. Some people discover

that

> eating junk food, or eating all day long by " grazing " helps them to

> feel more sense of satisfaction and fulfillment -- but weight loss

is

> defeated. In a sense, the operation tends to encourage behavior

> which defeats its objective.

>

> Overall, about 40% of persons who have this operation never achieve

> loss of more than half of their excess body weight. In the long

run,

> five or more years after surgery, only about 30% of patients have

> maintained a successful weight loss. Many patients must undergo

> another, revisional operation, to obtain the results they seek.

>

> Because of the poor reported results with this surgery, we do not

> recommend or offer it - we can achieve far better results, with no

> increased risk, or increased expense. When revision of a

> Gastroplasty is necessary, we recommend conversion to a Gastric

> Bypass.