Ten Crucial Steps for the MGB Operation

The mini-gastric bypass (MGB) was introduced by Dr. Robert Rutledge in USA in 1997. It is a safe, rapid and effective bariatric operation. The MGB has slowly gained proponents throughout the world, particularly increasing in the past 5 years. The laparoscopic operation creates two components: first, a mildly restrictive lesser-curvature gastric pouch; second, a 150–200 cm long jejunal bypass with a single antecolic gastro-jejunostomy anastomosis, which leads to significant fat malabsorption. We hereby share our steps in operative technique. MGB was performed using five trocars. The steps include creation of a lesser omental window, creation of gastric pouch, gastrotomy, measuring the bypass limb, enterotomy and gastro-jejunostomy, followed by leak test. MGB is an excellent surgical modality for treatment of morbid obesity and its co-morbidities, with results even better than Roux-en- Y Gastric Bypass. However, it is very important to follow the correct steps to avoid complications.