Mini gastroplasty Dr Rutledge MG, MSG

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Transcript of Mini gastroplasty Dr Rutledge MG, MSG

Most Surgeons Do Not Understand the MGB

The Mini-Gastroplasty (MGB, Part 1)Many surgeons do not understand the mechanism

and power of the MGB!

1.The Gastric Pouch = Mini-Gastroplasty

2.The Billroth II = Bilio-Pancreatic Bypass

Sleeve GastrectomyThe sleeve gastrectomy (SG) has gained popularity

because of several advantages. Unfortunately the SG surgery is irreversible. With High risk of GERD, Erosive Esophagitis

Barrett’sWeight Regain

Mini-GastroplastyThe MGB has used a gastric sleeve reconstruction since 1997. In selected Mini-Gastric Bypass patients the bypass portion was

omitted and only a “Mini” Sleeve Gastroplasty (MSG) was performed in 2 types of cases,

1: morbidly obese but unable/inappropriate to bypass or 2: for lesser weight loss. The MSG consisted sleeve type gastric

pouch. The neo-gastric tube is then reattached to the distal stomach

with a 1 cm diameter anastomosis.

Mini-GastroplastyShow Video

Mini-GastroplastyAnimal ModelCompared to NissenMG > Nissen Rx Reflux

Mini-GastroplastyAnimal ModelCompared to NissenMG > Nissen Rx Reflux

Mini-GastroplastyThe MGB since 1997. 1: morbidly obese but

unable/inappropriate to bypass or

2: for lesser weight loss. The MSG consisted sleeve type gastric pouch.

Mini-GastroplastyThe MGB since 1997. 1: morbidly obese but

unable/inappropriate to bypass or

2: for lesser weight loss. The MSG consisted sleeve type gastric pouch.

Mini-GastroplastyMini-Gastroplasty= 1/2 of the MGB= Based upon

Collis Gastroplasty

Mini-GastroplastyThe Mini-Gastric Bypass has used a

gastric "sleeve TYPE" reconstruction since 1997.

The Mini-Gastroplasty consists sleeve type gastric pouch. The neo-gastric tube is then reattached to the distal stomach

Methods: In selected "Mini-Gastric Bypass" patients

the bypass portion was omitted and only a “Mini” Gastroplasty (MG) was performed in 2 types of cases,

1: Morbidly obese but unable to bypass or

2: for lesser weight loss.

Mini-GastroplastyThe MG was chosen for

61 morbidly obese (MO) patients with an inability to perform a bypass and for

387 patients with Less Severe Obesity (LSO).

Mean preoperative BMI in MO patients was 45 kg/m2, and

Mean Excess Body Weight (EBW) was 64 kg.

Mini-GastroplastyThe mean BMI in LSO pts was 35 and the mean EBW was 32 kg.

There was no mortality. Mean weight loss was 30 kg (±10 kg), equivalent to 47% of EBW in MO patients.

Mean weight loss in LSO patients was 29 kg (±9 kg), equivalent to 86% of Excess BW.

Conclusions: Mini-GastroplastyThis describes the performance of the

Non-resectional "Mini" Sleeve Gastroplasty and confirms previous work showing that the results of the MG are similar to the Band and the Excisional (irreversible) Sleeve Gastrectomy.

ConclusionsThe MSG is simple and successful in Less Severely

Obese patients.

The Mini-Sleeve Gastroplasty avoids the foreign body of a band and unlike the Sleeve Gastrectomy is less likely to cause reflux easily reversible.