Page 37 - Journal of World Association of Laparoscopic Surgeons
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REVIEW ARTICLE
Comparison between Roux-en-Y Gastric Bypass and
Mini-gastric Bypass in Patients of Developing Countries
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George C Obonna ,MartinCObonna , Rajneesh K Mishra
AbstrAct
Background: The disease of obesity mostly common in the developed countries is also predominantly seen in the developing countries in
recent times. This is therefore a cause to worry.
Aim: To review literature comparing Roux-en-Y gastric bypass (RYGB) and mini-gastric bypass (MGB) to ascertain the more effective and safe
bariatric and metabolic operation.
Materials and methods: Detailed literature review online was perfected via Springer Link, International Bariatric Club, and the World Health
Organization. Of immense use was a database of 1,000 bariatric surgeries collated from multiple hospitals in the developing countries.
Conclusion: Both bariatric procedures are effective in the treatment of morbid obesity by restriction and malabsorption. They resolve obesity-
related metabolic complications and hence increase quality of life for morbidly obese patients. However, in their comparison, MGB take lesser
time to perform than RYGB. Also, MGB has shown to be simpler and safer surgery than RYGB. Thus, in the developing country, with its high
population and increasing prevalence of morbidly obese individuals, MGB procedure can be used to treat more patients and also reduce the
time and energy taken to manage the patient because of its technical ease, efficacy, revisibility, and reversibility. Overall, a zero mortality in
MGB makes it the gold standard in bariatric surgery.
Keywords: Laparoscopy, Mini-gastric bypass, Roux-en-Y gastric bypass.
World Journal of Laparoscopic Surgery (2019): 10.5005/jp-journals-10033-1360
IntroductIon 1 Department of Surgery, University of Medical Science UNIMED Ondo
Obesity has become a problem worldwide and currently severely State, Nigeria
ravaging the developing countries. The developing countries 2 College of Medicine, Abia State University, Uturu, Nigeria
include the recently industrialized countries such as India, China, 3 World Laparoscopy Hospital, Gurugram, Haryana, India; Department
and many South and Central American countries. Chair, Minimal Access Surgery, TGO University, India
The developed countries such as the Western Europe, Japan, Corresponding Author: George C Obonna, Department of Surgery,
South Korea, Australia, United States, Canada, Israel, and New University of Medical Science UNIMED Ondo State, Nigeria, Phone:
Zealand have been living in affluence which is highly associated +234 8120206423, e-mail: obogeo2009@yahoo.com
with endemic obesity. The diffusion of western cultural norms has How to cite this article: Obonna GC, Obonna MC, Mishra RK, et al.
fuelled widespread trends of obesity in developing countries in Comparison between Roux-en-Y Gastric Bypass and Mini-gastric Bypass
recent times. Increasing adiposity, improved hygiene and public in Patients of Developing Countries. World J Lap Surg 2019;12(1):29–32.
health services, vaccination and basic amenities, such as safe Source of support: Nil
drinking water, have led to better lifespan long enough to develop Conflict of interest: None
problems linked to obesity which included cardiovascular disease
and metabolic disorders such as diabetes mellitus, osteoarthritis, Being technically simpler, MGB is a safe and effective alternative
and liver cirrhosis. A BMI of 37.5 is classified as severe obesity to the previous gold standard RYGB with equal results plus the
and surgery remains the weight-reducing gold standard in the advantage of being technically simpler with lower complication
treatment of such individuals. Follow-up of these patient is the rates and impact more on the quality of life of the patients.
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Achilles’ heel of every bariatric program, because in the absence Surgery has become the best treatment for morbid obesity
of continuous contact with the patient, the surgeon loses feedback as has been universally accepted. Both open and minimally
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from the patient. Even though some comorbidities of obesity, invasive laparoscopic surgeries are effective in the management
such as essential hypertension and type 2 diabetes, have been of morbid obesity. Laparoscopy is associated with postoperative
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considered in the health bill of the developing countries, obesity complications and requires more operative time and an almost
itself has not. A few hospitals are trying to perform bariatric vertical learning curve. Apart from the occurrence of marginal
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surgery in the developing countries; however, this procedure is in ulcers and reflux bilious gastritis, mini-gastric bypass also known
direct competition with other digestive system surgeries such as as one anastomosis gastric bypass is easier and adequate enough
gastric cancer and cholelithiasis, both of which are highly prevalent than Roux-en-Y gastric bypass in the treatment of morbid obesity.
diseases in the developing country.
This situation means that there are extensive waiting lists for
bariatric surgery in the developing countries. The mini-gastric AIm
bypass (MGB) which subserves a lesser operating time than Roux- The aim is to compare RYGB with MGB with the view of drawing
en-Y gastric bypass (RYGB) is thus preferred in this circumstance. inference on which is best in the treatment of morbid obesity.
© The Author(s). 2019 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (https://creativecommons.
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