Laparoscopic Minigastric Bypass vs. Laparoscopic Sleeve Gastrectomy- Metabolic Surgery for Morbid Obesity with Remission of Diabetes and Co-morbidities and Effective Weight Loss

Ajay H Bhandarwar, MS, Saurabh S Gandhi, MS, Chintan B Patel, MS, Amol N Wagh, MS, Priyank D Kothari, Eham L Arora. Grant Government Medical College

Introduction: Morbid obesity is a worldwide pandemic and has a strong association with diabetes mellitus and other co-morbidities. Procedures for obesity surgery lead to remission of metabolic diseases to a good extent. Laparoscopic sleeve gastrectomy (SG) and Laparoscopic single anastomosis mini-gastric bypass (MGB) are 2 commonly used procedures. Despite many thousands of published cases, MGB continues to be controversial and many national societies do not regard it as a mainstream bariatric procedure.nOur study aims to prove the efficacy of Laparoscopic MGB by comparing with LSG (a procedure well accepted by international society) in terms of weight loss and remission of diabetes mellitus and other co morbidities specifically in Asian population.

Materials and Methods: 85 matched patients out of 120 were selected with morbid obesity randomized into groups.(n=43) underwent MGD and (n=42) underwent LSG. Patients were followed up post op at 6 ,12 and 24 months in both the groups. Both groups were compared statistically in terms of loss of weight ,remission of diabetes,hypertension and obstructive sleep apnoea and dyslipidimia.3 patients were lost to follow up, 1 in LSG group and 2 in MGB group.1 patient in LSG group had marginal ulcers and underwent revision rou-en y gastrectomy.These were excluded from the analysis.

Conclusion: Thousands of cases of Laparoscopic mini-gastric bypass have been reported in literature with proven results though it is not widely worldwide. In our study it proved to result in more effective weight loss and co morbidity reduction compared to sleeve gastrectomy. Duodenal exclusion in mini-gastric bypass may have led to the incretin effect. Further studies with long term follow up are required to substantiate the effectiveness and long term outcome of procedure for better international acceptance.