MGB/OAGB TP RYGB REVISION

Service Description

Revising a Mini Gastric Bypass (MGB)—also known as One-Anastomosis Gastric Bypass (OAGB)—to a Roux-en-Y Gastric Bypass (RYGB) is a complex but effective surgical revision, typically performed when patients experience bile reflux, severe GERD, malnutrition, or technical issues related to the original loop configuration. 🔄 MGB/OAGB to RYGB Revision Converting from loop to Roux-en-Y to resolve complications or improve outcomes Why Revise MGB to RYGB? - Bile reflux or GERD: MGB allows bile to reach the gastric pouch and esophagus - Anastomotic ulcer: Often bile-induced and resistant to medical therapy - Malnutrition: Excessive length of bypassed small bowel (common with MGB) - Technical complications: Long pouch, kinking, or marginal ulcers - Patient intolerance: Persistent nausea, dumping, or severe diarrhea 🛠️ What Does the Revision Involve? Step-by-step overview: 1. Identify and divide the existing gastrojejunal anastomosis 2. Create a new Roux-en-Y configuration: - Convert loop into two limbs: · Alimentary limb (carries food) · Biliopancreatic limb (carries digestive enzymes) - Perform a new jejunojejunostomy to complete the Roux-en-Y 3. Optional: Resize the pouch or revise the gastrojejunostomy This surgery requires advanced experience due to adhesions, altered anatomy, and risk of leaks. ✅ Benefits of MGB ➝ RYGB Revision - Resolves bile reflux: Classic RYGB anatomy prevents bile from reaching the pouch or esophagus - Reduces ulcer risk: Eliminates continuous bile exposure - Improves symptoms: Less diarrhea, less dumping, more tolerable digestion - Maintains weight loss: Preserves restriction and bypass effect - Allows endoscopic access to remnant stomach & biliary tree: Via the excluded duodenum ⚠️ Risks & Considerations - Adhesions and scar tissue: Common after prior bypass surgery - Leak risk: Especially at new anastomoses - Nutritional deficiencies: May persist or worsen temporarily - Recovery time: Can be longer than primary RYGB 📈 Outcomes - Bile reflux resolution: 85–95% - Weight loss maintenance: Yes (similar to MGB or RYGB) - Ulcer healing: Typically complete if bile is excluded 🧠 Summary Converting a Mini Gastric Bypass to Roux-en-Y is the preferred solution for patients experiencing bile reflux, anastomotic ulcers, or malabsorption issues. While more technically demanding, this revision offers substantial symptom relief and allows continued metabolic benefit with better digestive tolerance.