Mini Gastric Bypass Surgery (MGBP) (“Loop Gastric Bypass”)

Mini gastric bypass surgery is a short and relatively simple procedure that has been shown by the available research to have low risk and result in good short and long-term weight loss.

So why do many surgeons warn against it and why doesn’t insurance cover it? This page will explore these questions along with all other MGBP considerations, including…

mini gastric bypass surgery

Could Mini Gastric Bypass Surgery Be Right for You?

As the name suggests, mini gastric bypass surgery is a simplified form of Roux-en-Y gastric bypass surgery (RNY). A thorough review of the studies that specifically evaluated the effectiveness of MGBP shows that the procedure is shorter, easier, less expensive and has lower risk and equally successful outcomes as RNY.

Even though MGBP sounds like an obvious choice between the two procedures, there are a few signifigant reasons why this might not always be the case…

  1. Mini gastric bypass usually bypasses much more of the intestine than a standard gastric bypass which could lead to more vitamin and mineral deficiencies.
  2. Unlike gastric bypass surgery, digestive enzymes and bile are not diverted away from the stomach after mini gastric bypass. This can lead to bile reflux gastritis which can cause pain that is difficult to treat. Bile reflux gastritis may also increase the risk of cancer in the stomach pouch.
  3. Most insurance companies don’t cover MGBP surgery costs as they still consider it an experimental procedure
  4. Because of the reasons above, experienced surgeons are less likely to offer mini gastric bypass than gastric bypass. This will make it more difficult for you to find a local qualified surgeon willing to perform the procedure.
  5. More long-term research is needed to solidify mini gastric bypass surgery’s position as a viable bariatric surgery option

Scroll down to continue your mini gastric bypass research.

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The Difference Between Mini Gastric Bypass Surgery and Other Bariatric Surgery Procedures

The Procedure section below will review exactly how mini gastric bypass surgery differs from Roux-en-Y gastric bypass.

First, let’s review the studies that directly compare the two (findings summarized below the chart)…

Summary of Studies Comparing Mini Gastric Bypass to Laparoscopic Roux-en-Y Gastric Bypass Surgery (RNY) Year of Study
References: A, B, C, Q
*For simplicity, all acronyms and procedure names have been changed to a common name (i.e. LMBG, LMGBP and Laparoscopic Mini Gastric Bypass were changed to mini gastric bypass).
This study demonstrates that LMGBP (mini gastric bypass) can be regarded as a simpler and safer alternative to LRYGB (RNY gastric bypass) with similar efficacy at a 10-year experience.Q 2012
Pending long-term evaluation, mini gastric bypass seems a good alternative to RNY, giving the same results with a more simple and reproducible technique.A 2008
Previous studies have demonstrated that hospitalization after RNY gastric bypass increases remarkably (20% per year). The present study shows that hospitalization following mini gastric bypass instead of rising, as reported with RNY, decreases by a third. The mini gastric bypass has been shown to be a short, safe successful weight loss surgery in previous work. The present study supports the mini gastric bypass as a low risk procedure that decreases the need for hospitalization.B 2006
Both RNY gastric bypass and mini gastric bypass are effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life. Mini gastric bypass is a simpler and safer procedure that has no disadvantage compared with RNY at 2 years of follow-up.C 2005

In summary, compared with Roux-en-Y gastric bypass surgery, mini gastric bypass surgery appears to be…

  • A simpler procedure
  • Equally as effective for morbid obesity with similar results for resolution of metabolic syndrome and improvement of quality of life
  • Simpler and safer procedure with no disadvantages after 2 years of follow-up
  • Better in terms of hospitalization rates following surgery

But as mentioned above...

  1. The large amount of intestines that is bypassed could lead to more vitamin and mineral deficiencies.
  2. Mini gastric bypass may lead to higher rates of bile reflux gastritis which can be painful, hard to treat and potentially increase stomach cancer risks.

Now let’s review the research that has evaluated the results of surgery and specifics about related complications.

If you'd like to further compare mini gastric bypass surgery to other procedures, see our Types of Bariatric Surgery page.

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Results of Mini Gastric Bypass Surgery

The following 4 studies agree with the mini gastric bypass findings sited in the section above

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  • It’s costs may be lower than other types of surgery, but experienced surgeons are likely to charge an amount similar to gastric bypass
  • It may be simpler and safer than other surgeries
  • Need for hospitalization following surgery appears to be lower than with other surgeries
  • It has a similar impact on obesity health issues as Roux-en-Y gastric bypass surgery

The following studies also site this negative…

  • Like other procedures, there is a chance that a revision will be necessary after mini gastric bypass surgery. For those who need it, conversion to Roux-en-Y gastric bypass appears to be a viable option.
Summary of Findings Year
References: D, EFGH,P
*For simplicity, all acronyms and procedure names have been changed to a common name (i.e. LMBG, LMGBP and Laparoscopic Mini Gastric Bypass were changed to mini gastric bypass).
MGB is an effective, relatively low-risk, and low-failure bariatric procedure. In addition, it can be easily revised, converted, or reversed.P 2012
126 patients undergoing mini gastric bypass from October 2004 to October 2006, were reviewed at an academic institution. Mini gastric bypass is a simple, safe, effective and low-cost gastric bypass.D 2007
Mini gastric bypass resulted in significant and sustained weight loss with successful treatment of [type 2 diabetes] up to 87.1%. Despite a slightly lower response rate of type 2 diabetes treatment, patients with a body mass index (BMI) <35 still had an acceptable diabetes resolution, and this treatment option can be offered to this group of patients.E 2007
This preliminary review confirms that mini gastric bypass does require revision in some patients and that conversion to Roux-en-Y Gastric Bypass (RNY) is a common form of revision, despite the fact that the denominator of mini gastric bypass cases performed during this time frame is not known. The need for mini gastric bypass revision is underestimated as the data reflect the experience of only 3 hospitals. Most worrisome is the frequency of complications being managed by surgeons who did not perform the original procedure. A randomized trial comparing mini gastric bypass to RNY is indicated before widespread adoption of the loop procedure. A national registry to record complications of mini gastric bypass is proposed to gain insight into the need for revision after mini gastric bypass.F 2006
The study is a self reported retrospective study of patients from across the United States receiving mini gastric bypass in Centers for Excellence in Laparoscopic Obesity Surgery (“CELOS”) hospitals from 2000 to 2005. The mini gastric bypass has been shown to be a short, safe and successful weight loss surgery in previous work. The present study supports the mini gastric bypass as a low risk procedure that decreases the need for hospitalization.G 2006
Overall (6 years and 2,410 patients), the mini gastric bypass is very safe initially and in the long-term. It has reliable weight loss and complications similar to other forms of gastric bypass.H 2005

In regards to the amount of weight you can expect to lose, mini gastric bypass surgery will take off between 58% and 80% over the short term. As with all bariatric surgery procedures, weight regain does occur, but most patients are able to keep at least 60% of the excess weight off over the long term…

Studies # of mini gastric bypass Patients Weight Loss
(% of Excess Weight Lost at...)
Year
References: I, J, K,P, Q
Study P 1,000 1.5 Years - 72.5%
5 Years - 68.6%
2012
Study Q 1,163 5 years - 72.9% 2012
Study I 126 1 Year – 68.4% 2007
Study J 80 1 Year – 58.7%

2 Years – 60%
(95% of patients kept at least 50% of excess weight off after 2 years)
2005
Study K 2,410 1 Year – 80%

5 Years – 95% of patients kept more than 66.4% of the excess weight off
2005

Hear It Straight from the Source... For Free

Most surgeons offer free seminars and/or free one-on-one consultations that teach you about your options and their office's specific results.

Click here to find and schedule a free in-person seminar or one-on-one consultation with a qualified weight loss surgeon in your area.

Otherwise, continue below for the rest of the mini gastric bypass surgery details, including risks, details about the procedure, recovery, life after surgery and cost.

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Mini Gastric Bypass Surgery Complications & Risks

Complications occur in up to 7.5% of patients during and after mini gastric bypass, although only 1.7% of patients require revisional surgery.6 Complications include (% of patients experiencing them included when available)…

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Some of the above are minor and easily treated while others can be more serious. For definitions and treatments of each, see our Bariatric Surgery Complications page. That page will also show you how to reduce your risks and improve your chances for success.

On top of the relatively low complication rate, the mortality rate is close to 0%. Following is a summary of both mortality and complication rates from 4 separate studies…

Studies # of mini gastric bypass Patients Mortality/Complication Rate Year of Study
References: LM, NO
Study P 1,000 30 day mortality - 0%
Short term complications - 2.7% (primary surgery); 11.6% (revision surgery)
2012
Study Q 1,163 Major complications - 1.8% 2012
Study L 644 Mortality - 0.16%
Minor complications – 4.3%
Major complications – 2%
2008
Study M 100 Mortality - 0%
Major complications – 7%
2008
Study N 126 Mortality - 0%
In-hospital complication rate – 4.7%
2007
Study O 40 Mortality - 0%
Complication - 7.5%
2005

When deciding whether the complication and mortality risks are “worth it”, it’s a good idea to evaluate the potential risks associated with not having surgery. See our Life After Weight Loss Surgery, Obesity Health Problems and Cause and Effect of Obesity pages for more on this.

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The Mini Gastric Bypass Surgery Procedure

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In the laparoscopically performed MGBP, a tube-shaped chamber is partitioned from the stomach at the base of the esophagus and is connected about six feet down the small intestine. Surgery time for the MGBP is a little over 2 hours on average.2

Following are two videos – computer animated and the actual procedure being performed - to provide you with a better understanding…

Computer animated video explaining the mini gastric bypass procedure

(click here to skip past video of actual procedure being performed)

Video of actual MBGP procedure being performed

Roux-en-Y laparoscopic gastric bypass surgery, on the other hand, is much more complicated. Unlike mini gastric bypass, with RNY the small intestine is cut and two connections are made instead of one. In addition, the pouch created during the mini gastric bypass is larger.

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Recovery from Mini Gastric Bypass Surgery

Some surgeons claim that, if all goes well, they’ll have you out of the hospital within 24 hours of surgery, however it’s better to count on staying between 3 and 5 days.3,4 

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In order to prevent blood clots and blood clot symptoms and to promote healing, your doctor will have you up and moving as soon as possible following surgery. Special stockings or machines may be used on your legs to further help with blood clot prevention.

As with all other types of bariatric surgery, your surgeon will start you out on a liquid diet and will have you slowly transition you back to solid foods. Our Bariatric Diet section reviews all of the details.

Return to work may be possible in a week, but play it safe and take at least 2 weeks off for rest and recuperation.

See our Life After Weight Loss Surgery page for all of the details about bariatric surgery recovery.

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Life After Mini Gastric Bypass Surgery

Life will significantly change after surgery as it would after all types of bariatric surgery.

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Given the lack of long-term research for mini gastric bypass surgery, a prediction about long-term changes is purely speculative.

Certain similarities between the mini gastric bypass and other procedures suggest that you could expect…

  • Diarrhea or loose stools as a potential side effect. If this happens, diet should be carefully observed to determine and avoid the cause.
  • Constipation may also present itself, especially if you aren’t drinking enough water or getting enough fiber in your diet.
  • Difficulty swallowing can be the result of any restrictive procedure. Choosing foods with a smoother texture, eating more slowly and chewing your food more thoroughly will usually fix the problem. (See our Bariatric Eating page to learn about proper eating techniques that will avoid problems.)

In addition to discussing recovery, our Life After Weight Loss Surgery page explains the changes patients experience for all types of bariatric surgery.

See our Bariatric Diet section for more about what your eating habits will be like.

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Mini Gastric Bypass Surgery Cost

There is a wide variation in cost of this procedure... anywhere from $7,000 up to $25,000 or more. More experienced surgeons in the United States are likely to charge similar amounts as they would for gastric bypass surgery.

In addition, there is typically no bariatric surgery insurance for this procedure as it is still considered experimental, so if you can’t afford to pay for the entire surgery yourself you’ll need to look into financing bariatric surgery.

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Bariatric doctors specializing in Mini Gastric Bypass Surgery

Since most experienced surgeons recommend gastric bypass over mini gastric bypass for the reasons mentioned above, we hesitate to recommend this procedure.

If you decide to pursue this option, follow the advice on our Bariatric Doctors page closely to ensure that you choose a surgeon with the right level of experience.

Even better, work with a surgeon who also has many Roux-en-Y gastric bypass procedures under his or her belt. They will be able to tell you from experience which surgery is better for your specific situation and why.  They can also refer you to both their RNY and MGBP patients to help you further investigate which procedure is best for you.

In addition to the methods recommended on our Bariatric Doctors page, you can also search for surgeons in your area using our directory of bariatric surgeons (includes all surgeons designated as Centers of Excellence as well as recommedations from other visitors):

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References

  1. Rutledge R, Walsh TR. Continued excellent results with the mini-gastric bypass : Six-year study in 2,410 patients. Obesity Surgery 2005, vol. 15, no9, pp. 1304-1308.
  2. Noun R, et al. Mini-gastric bypass by mini-laparotomy: a cost-effective alternative in the laparoscopic era. Obes Surg. 2007 Nov;17(11):1482-6.
  3. Kelly, Donna. Mini-gastric bypass surgery gives hope to many with weight struggles. NewsChief.com. February 2009. Available at: http://www.newschief.com/article/
    20090202/NEWS/902020324?Title=Mini-gastric-bypass-surgery-gives-hope-to-many-
    with-weight-struggles. Accessed: September 29, 2009.
  4. Chakhtoura G, et al. Primary Results of Laparoscopic Mini-Gastric Bypass in a French Obesity-Surgery Specialized University Hospital. Obesity Surgery, Volume 18, Number 9, September 2008 , pp. 1130-1133.
  5. Collins BJ, et al. Gastric Bypass - Why Roux-en-Y? A Review of Experimental Data. Arch Surg. 2007;142(10):1000-1003.
  6. Wei-Jei Lee, Yi-Chih Lee, Kong-Han Ser, Shu-Chun Chen, Jung-Chien Chen, Yen-How Su. Revisional surgery for laparoscopic minigastric bypass. Surgery for Obesity and Related Diseases - 01 November 2010 (10.1016/j.soard.2010.10.012)

[Last editorial review/modification of this page: 2/19/2014]

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