MINI GASTRIC BYPASS 2.0 IN PATIENTS WITH BMI 35–40 AND COMORBIDITIES: A PROSPECTIVE STUDY OF 41 CASES AND EVALUATION OF JEJUNOJEJUNOSTOMY AS A TECHNICAL MODIFICATION drpremk512@gmail.com

 

MINI GASTRIC BYPASS 2.0 IN PATIENTS WITH BMI 35–40 AND COMORBIDITIES: A PROSPECTIVE STUDY OF 41 CASES AND EVALUATION OF JEJUNOJEJUNOSTOMY AS A TECHNICAL MODIFICATION

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India

Oral only

Mini Gastric Bypass (MGB), pioneered by Dr. Robert Rutledge in 1997, was designed as a simpler, single-anastomosis alternative to Roux-en-Y gastric bypass with favorable weight loss and metabolic outcomes. To address concerns related to bile reflux and optimize anatomical flow, Rutledge later evolved the technique into MGB 2.0, introducing anterior gastric plication along with a long, narrow gastric pouch placed along the greater curvature, followed by a loop gastrojejunostomy.

A prospective observational study was conducted between April 2024 and June 2025 at a single tertiary care center in India. 41 patients with BMI ranging between 35–40 kg/m², all presenting with at least one obesity-related comorbidity (type 2 diabetes mellitus and/or hypertension), were included. All underwent MGB 2.0 with anterior gastric plication.

Average weight loss was 16 kg at a median follow-up of 9 months. Diabetes remission (complete or partial) was achieved in 60% of patients. Hypertension control improved in 46%, allowing reduction or cessation of antihypertensive medications. However, 64% of patients reported significant postoperative vomiting, warranting surgical reintervention

MGB 2.0 is a viable and effective surgical strategy in the Indian population with BMI 35–40 and associated metabolic conditions. The addition of jejunojejunostomy in patients experiencing postoperative vomiting may enhance the safety and tolerance of the procedure.