"MGB vs RNY"

I Give Up

I Surrender the Debate

MGB is NOT Here to "Kill" Anything

But I am Also Hereto

Declare Victory

The MGB has Won

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...

In Short The Critics Were Wrong

About Everything

Do Not Have TimeAddress Every Critical Error

Address Three:

1. MGB = Old Mason Loop

2. Fear of Bile Reflux

3. Fear of Gastric Cancer

Critics Wrong1. MGB = Old Mason Loop

• In Short:

• Mason Loop = Total Gastrectomy + Billroth II (Wrong)

• MGB = Antrectomy + Billroth II(Right)

Critics Wrong1. 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

Critics Wrong2. Fear of Bile Reflux

• In Short:

• General Surgery: 130 yrs Billroth II; Bile Reflux RARELY a Problem

• MGB Results70+ Articles, 16,000+ cases, 10-15 yr FU, Reports from Americas, Europe, AsiaBile Reflux RARELY a Problem

Critics Wrong2. 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

Critics Wrong3. 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)

Critics Wrong3. 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

Critics Wrong3. 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

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