Robert Rutledge1, Kuldeepak Kular2, Naveen Manchanda3. 1. Department of Surgery, Kular Hospital Pvt. Ltd., National Highway 1, Bija, Khanna, Ludhiana, Punjab, 141412, India; CLOS, The Center for Laparoscopic Obesity Surgery, 79405, Highway 111 Ste 9-216, La Quinta, Ca, USA. Electronic address: DrRutledge@gmail.com. 2. Department of Surgery, Kular Hospital Pvt. Ltd., National Highway 1, Bija, Khanna, Ludhiana, Punjab, 141412, India. Electronic address: drkskular@gmail.com. 3. Department of Surgery, Kular Hospital Pvt. Ltd., National Highway 1, Bija, Khanna, Ludhiana, Punjab, 141412, India. Electronic address: naveenmanchanda2412@gmail.com.
Abstract
INTRODUCTION: Mini-Gastric Bypass (MGB) is becoming more and more popular as shown by the numerous articles published over the past 15 years, supporting the operation as a short and simple procedure with excellent outcomes and low complication rates. There is still confusion amongst surgeons on the technique of the operation. The purpose of this paper is to review and describe the technique of MGB by its originators. METHODS: With 20 years of experience of performing the original MGB, the authors present the details of the MGB. RESULTS: The MGB consists of a long conduit from below the crow's foot extending up to the left of the angle of His. It is similar to, but importantly, not the same as the pouch of the Sleeve Gastrectomy. MGB has a wide gastro-jejunal anastomosis to an anti-colic loop of jejunum 150-200 cm distal to the ligament of Trietz. The power of MGB comes from the fact that it is both a "Non-Obstructive" restrictive procedure and it also has a significant fatty food intolerance component with minimal malabsorption. CONCLUSION: In this article we describe the original Rutledge technique of Mini-Gastric Bypass. Notably this is neither a "Single Anastomosis bypass", nor an "Omega Loop Bypass" and also not the "One Anastomosis Bypass of Carbajo". It is a particular technique first created by Rutledge in 1997 and associated with low risk and excellent outcomes. The goal of this manuscript is to help avoid complications and problems seen when the operation deviates from some of the basic principles of general surgery used in the original operation.
INTRODUCTION: Mini-Gastric Bypass (MGB) is becoming more and more popular as shown by the numerous articles published over the past 15 years, supporting the operation as a short and simple procedure with excellent outcomes and low complication rates. There is still confusion amongst surgeons on the technique of the operation. The purpose of this paper is to review and describe the technique of MGB by its originators. METHODS: With 20 years of experience of performing the original MGB, the authors present the details of the MGB. RESULTS: The MGB consists of a long conduit from below the crow's foot extending up to the left of the angle of His. It is similar to, but importantly, not the same as the pouch of the Sleeve Gastrectomy. MGB has a wide gastro-jejunal anastomosis to an anti-colic loop of jejunum 150-200 cm distal to the ligament of Trietz. The power of MGB comes from the fact that it is both a "Non-Obstructive" restrictive procedure and it also has a significant fatty food intolerance component with minimal malabsorption. CONCLUSION: In this article we describe the original Rutledge technique of Mini-Gastric Bypass. Notably this is neither a "Single Anastomosis bypass", nor an "Omega Loop Bypass" and also not the "One Anastomosis Bypass of Carbajo". It is a particular technique first created by Rutledge in 1997 and associated with low risk and excellent outcomes. The goal of this manuscript is to help avoid complications and problems seen when the operation deviates from some of the basic principles of general surgery used in the original operation.
Authors: Robert Rutledge; Mervyn Deitel; Miguel A Carbajo; Enrique Luque-de-Leon; Sonja Chiappetta; Aatif Inam; Karl Rheinwalt; Arun Prasad; David E Hargroder; Vladimir Samoylov; M Mahir Ozmen; Chetan Parmar; António Albuquerque; Gurvinder Jammu; Murat Ustun; Nasser Sakran; Recep Aktimur; Amir Khan; Yasser Hamza; Adriana Rotundo; Marc Focquet; Michael Van den Bossche; Om Tantia; Francesco Greco; Midhat Abu Sneineh; Francisco Barrera Rodriguez; Mario Musella; Miroslav Ilić; Imran Abbas Journal: Obes Surg Date: 2020-02 Impact factor: 4.129
Authors: Mahmoud Haggag; Ali Salem; Ahmad M Sultan; Ahmed N Elghawalby; Rehab T Eldesoky; Sara A Eldegwi; Nabil Gad Elhak; Ahmed Shehta Journal: Turk J Surg Date: 2021-12-31
Authors: Diego Paim Carvalho Garcia; Cyntia Ferreira Dos Reis; Luiza Ohasi de Figueiredo; Guilherme Vaz de Melo Mota; Leonardo Quinete Guimarães; Fernando Augusto de Vasconcellos Santos; Luiz Ronaldo Alberti; Thiago de Almeida Furtado Journal: Ann Med Surg (Lond) Date: 2019-11-17
Authors: Rafael C Katayama; Carlos H Arasaki; Fernando A M Herbella; Ricardo A Neto; Gaspar de Jesus Lopes Filho Journal: J Obes Metab Syndr Date: 2021-12-30
Authors: Piotr Małczak; Magdalena Mizera; Yung Lee; Magdalena Pisarska-Adamczyk; Michał Wysocki; Małgorzata M Bała; Jan Witowski; Mateusz Rubinkiewicz; Alicja Dudek; Tomasz Stefura; Grzegorz Torbicz; Piotr Tylec; Natalia Gajewska; Tanawat Vongsurbchart; Michael Su; Piotr Major; Michał Pędziwiatr Journal: Obes Surg Date: 2021-10-11 Impact factor: 4.129