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…

• Could MGBP surgery be right for you?
• What’s the difference between MGBP and other bariatric surgery procedures?
• Results of Surgery including average weight lost and impact on co-morbidities
• Complications & Risks
• The Procedure (explanation & videos)
• Recovery
• Life after MGBP surgery
• Cost of surgery & bariatric surgery insurance and financing
• Bariatric doctors specializing in Mini Gastric Bypass

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. Since it is much easier to perform, there are many surgeons without enough experience or proper training
2. Most insurance companies don’t cover MGBP surgery costs as they still consider it an experimental procedure
3. More long-term research is needed to solidify mini gastric bypass surgery’s position as a viable bariatric surgery option

This last point is the main reason that most Roux-en-Y gastric bypass surgeons currently refuse to perform the mini gastric bypass.

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)…

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 with no disadvantages after 2 years of follow-up
• Better in terms of hospitalization rates following surgery

Again, despite these positive conclusions, more research is needed to verify the long-term results.

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.

Results of Mini Gastric Bypass Surgery

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

• It’s costs are lower than other types of surgery
• 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.

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…

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)…

• Abdominal hernia
• Abscesses
• Anemia (4.9%)1
• Bile reflux gastritis
• Postoperative Bleeding
• Dyspepsia (5.6% of patients)1
• Esophagitis
• Gastrointestinal leak (1.08% of patients)5
• Incisional hernias (3.9% of patients)2
• Malabsorption
• Marginal ulcers (2.3% - 5.6%)1,2
• Peritonitis
• Pneumonia
• Stenosis
• Wound sepsis (2.3% of patients)2

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…

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.

The Mini Gastric Bypass Surgery Procedure

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.

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 

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.

Life After Mini Gastric Bypass Surgery

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

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.

Mini Gastric Bypass Surgery Cost

At a cost of between $7,000 and $10,000, mini gastric bypass surgery is significantly less expensive than other types of bariatric surgery. However, some surgeons and hospitals do charge more – we have seen surgery costs as high as $17,000 or more.

There is typically no bariatric surgery insurance for this procedure as it is still considered experimental (hopefully not for too much longer), so if you can’t afford to pay for the entire surgery yourself you’ll need to look into financing bariatric surgery.

If the high price tag of surgeons close to home is an issue, you may also want to consider bariatric surgery in Mexico or abroad.

Bariatric doctors specializing in Mini Gastric Bypass Surgery

Mini gastric bypass surgery could be a great option, but we are very concerned about the number of doctors performing this surgery who may not have enough experience. It also lacks a sufficiet amount of long-term research, which is the reason why so many Roux-en-Y gastric bypass surgeons won't perform it and the reason why it's not covered by insurance.

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):

• Find a bariatric surgeon in my area

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: 1/24/2012]