Critics of the Mini-Gastric Bypass were Wrong MGB Results In Short By every measure In every study By Every Author MGB Equal to or Better Than any other form of Bariatric Surgery Critics Wrong In Short: Bariatric Surgeons who are well educated in the Basics of General Surgery Choose the Mini-Gastric Bypass

1. "MGB vs RNY"

2. I Give Up
I Surrender the Debate
MGB is NOT Here to
"Kill" Anything

3. But I am Also Here
to
Declare Victory

4. The MGB has Won

5. First MGB; Rutledge 1997
• Criticisms
• MGB is the Old Mason Loop
• Must take out Gallbladder
• MGB will not lose weight
• Dr Rutledge website & uses Email!
• Bile Reflux
• Gastric Cancer
• Many more...

6. In Short
The Critics Were Wrong
About Everything

7. Do Not Have Time
Address Every Critical Error
Address Three:
1. MGB = Old Mason Loop
2. Fear of Bile Reflux
3. Fear of Gastric Cancer

8. Critics Wrong
1. MGB = Old Mason Loop
• In Short:
• Mason Loop =
Total Gastrectomy + Billroth II
(Wrong)
• MGB = Antrectomy + Billroth II
(Right)

9. Critics Wrong
1. MGB = Old Mason Loop
• In Short: MGB Critics Forget their
General Surgery
• General, Trauma & Oncologic
Surgeons Routinely USE Billroth II
• Bariatric Surgeons FEAR the
Billroth II

10. Critics Wrong
2. Fear of Bile Reflux
• In Short:
• General Surgery:
130 yrs Billroth II;
Bile Reflux RARELY a Problem
• MGB Results
70+ Articles, 16,000+ cases, 10-15 yr FU,
Reports from Americas, Europe, Asia
Bile Reflux RARELY a Problem

11. Critics Wrong
2. Fear Bile Reflux
• In Short: MGB Critics Forget their
General Surgery
• General, Trauma & Oncologic
Surgeons Routinely USE Billroth II
• Bariatric Surgeons FEAR the
Billroth II

12. Critics Wrong
3. Fear Gastric Cancer
• Many studies show NO increased Risk of GCA
• In studies that DO increased Risk the rate is very
small
• (Two cat scans more cancer risk than Billroth II in
worst case. Eating a Hot dog more dangerous than
BIllroth II)
• General Surgery:
• Billroth II pt; Should NOT have FU Endoscopy
RISK is TOO LOW
• Oncologic surgeons in areas of the the highest risk
of gastric cancer in the world use Billroth II routinely
(China Korea)

13. Critics Wrong
3. Fear Gastric Cancer
• If you wish to FEAR Cancer after Bariatric
Surgery
• Fear Esophageal Cancer after
Lap Band and Sleeve
• 30% or more post op GERD and erosive
esophagitis
• Known precursors of Esophageal Cancer and
one of the fastest rising cancers in USA

14. Critics Wrong
3. Fear Gastric Cancer
• In Short: MGB Critics Forget their
General Surgery
• General, Trauma & Oncologic
Surgeons Routinely USE Billroth II
• Bariatric Surgeons FEAR the
Billroth II

15. MGB Results
• In Short
• By every measure
• In every study
• By Every Author
• MGB Equal to or Better Than any
other form of Bariatric Surgery

16. Critics Wrong
• In Short:
• Bariatric Surgeons who are well
educated in the Basics of General
Surgery
• Choose the Mini-Gastric Bypass