Springer Nature is making SARS-CoV-2 and COVID-19 research free. View research | View latest news | Sign up for updates

Laparoscopic Roux-en-Y Vs. Mini-gastric Bypass for the Treatment of Morbid Obesity: a 10-Year Experience



Laparoscopic Roux-en-Y gastric bypass (LRYGB) is considered the gold standard for the treatment of morbid obesity but is technically challenging and results in significant perioperative complications. While laparoscopic mini-gastric bypass (LMGB) has been reported to be a simple and effective treatment for morbid obesity, controversy exists. Long-term follow-up data from a large number of patients comparing LMGB to LRYGB are lacking.


Between October 2001 and September 2010, 1,657 patients who received gastric bypass surgery (1,163 for LMGB and 494 for LRYGB) for their morbid obesity were recruited from our comprehensive obesity surgery center. Patients who received revision surgeries were excluded. Minimum follow-up was 1 year (mean 5.6 years, from 1 to 10 years). The operative time, estimated blood loss, length of hospital stay, and operative complications were assessed. Late complication, changes in body weight loss, BMI, quality of life, and comorbidities were determined at follow-up. Changes in quality of life were assessed using the Gastrointestinal Quality of Life Index.


There was no difference in preoperative clinical parameters between the two groups. Surgical time was significantly longer for LRYGB (159.2 vs. 115.3 min for LMGB, p < 0.001). The major complication rate was borderline higher for LRYGB (3.2 vs. 1.8 %, p = 0.07). At 5 years after surgery, the mean BMI was lower in LMGB than LRYGB (27.7 vs. 29.2, p < 0.05) and LMGB also had a higher excess weight loss than LRYGB (72.9 vs. 60.1 %, p < 0.05). Postoperative gastrointestinal quality of life increased significantly after operation in both groups without any significant difference at 5 years. Obesity-related clinical parameters improved in both groups without significant difference, but LMGB had a lower hemoglobin level than LRYGB. Late revision rate was similar between LRYGB and LMGB (3.6 vs. 2.8 %, p = 0.385).


This study demonstrates that LMGBP can be regarded as a simpler and safer alternative to LRYGB with similar efficacy at a 10-year experience.

This is a preview of subscription content, log in to check access.

Fig. 1
Fig. 2
Fig. 3


  1. 1.

    Buchwald H, Avidor Y, Braunwald E, et al. Bariatric surgery: a systematic review and meta-analysis. JAMA. 2004;292:1724–37.

  2. 2.

    Sjostrom L, Narbro K, Sjostrom D, et al. Effect of bariatric surgery on mortality in Swedish obese subjects. NEJM. 2007;357:741–52.

  3. 3.

    Rope GO, Birkmeyer JD, Finlnyeson S. National trends in utilization and in hospital outcome of bariatric surgery. J Gastrointest Surg. 2002;6:855–86.

  4. 4.

    Rutledge R. The mini-gastric bypass: experience with the first 1272 cases. Obes Surg. 2001;11:276–80.

  5. 5.

    Carbajo M, Garcia-Caballero M, Toledano M, et al. One-anastomosis gastric bypass by laparoscopy: results of the first 209 patients. Obes Surg. 2005;15:398–404.

  6. 6.

    Carbajo MA, Castro MJ, Kleinfinger S, et al. Effects of a balanced energy and high protein formula diet (Vegestrart complet®) vs. low-calorie regular diet in morbid obese patients prior to bariatric surgery (laparoscopic single anastomosis gastric bypass): a prospective, double-blind randomized study. Nutr Hosp. 2010;25:939–48.

  7. 7.

    Fisher BL, Buchwald H, Clark W, et al. Mini-gastric bypass controversy (letter). Obes Surg. 2001;11:773–7.

  8. 8.

    Johnson WH, Fernanadez AZ, Farrell TM, et al. Surgical revision of loop (“mini”) gastric bypass procedure: multicenter review of complications and conversions to Roux-en-Y gastric bypass. Surg Obes Relat Dis. 2007;3:37–41.

  9. 9.

    Lee WJ, Yu PJ, Wang W, et al. Laparoscopic Roux-en-Y versus mini-gastric bypass for the treatment of morbid obesity. Ann Surg. 2005;242:20–8.

  10. 10.

    Rutledge R, Walsh W. Continued excellent results with the mini-gastric bypass: six-year study in 2,410 patients. Obes Surg. 2005;15:1304–8.

  11. 11.

    Noun R, Riachi E, Zeidan S, et al. Mini-gastric bypass by mini-laparotomy: a cost-effective alternative in the laparoscopic Era. Obes Surg. 2007;17:1482–6.

  12. 12.

    Lee WJ, Wang W, Lee YC, et al. Effects of laparoscopic mini-gastric bypass for type 2 diabetes mellitus: comparison of BMI > 35 and <35 kg/m2. J Gastrointest Surg. 2008;12:945–52.

  13. 13.

    Chakhtoura G, Zinzindohoue F, Chevallier JM. Two-year results of laparoscopic mini-gastric bypass. Obes Surg. 2009;19:968(S).

  14. 14.

    Kim Z, Hur KY. Laparoscopic mini-gastric bypass for type 2 diabetes: the preliminary report. World J Surg. 2011;35:631–6.

  15. 15.

    Noun R, Skaff J, Riachi E, et al. One thousand consecutive mini-gastric bypass: short- and long-term outcome. Obes Surg. 2012;22:697–703.

  16. 16.

    Conference NIH. Gastrointestinal surgery for severe obesity. Ann Intern Med. 1991;115:959–61.

  17. 17.

    Lee WJ, Huang MT, Wang W, et al. Bariatric surgery: Asia-Pacific perspective. Obes Surg. 2005;15:751–7.

  18. 18.

    Expert Panel on Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults. Executive summary of the third report of the National Cholesterol Education Program (NECP) Expert Panel of Detection, Evaluation, and Treatment of High Blood Cholesterol in Adults (Adult Treatment Panel III). JAMA. 2001;285:2486–97.

  19. 19.

    Wang W, Wei PL, Lee WJ, et al. Short-term results of laparoscopic mini-gastric bypass. Obes Surg. 2005;15:648–54.

  20. 20.

    Espasch E, Williams JL, Wood-Dauphinee S, et al. Gastrointestinal quality of life index: development validation and application of new instrument. Br J Surg. 1995;82:216–22.

  21. 21.

    Decker G, Borie F, Bouamrirene D, et al. Gastrointestinal quality of life before and after laparoscopic Heller myotomy with partial posterior fundoplication. Ann Surg. 2002;236:750–8.

  22. 22.

    Lee WJ, Wang W, Yu PJ, et al. Gastrointestinal quality of life following laparoscopic adjustable gastric banding in Asia. Obes Surg. 2006;16:586–91.

  23. 23.

    Schauer P, Ikranuddin S, Gourash W, et al. Outcomes after laparoscopic gastric bypass for morbid obesity. Ann Surg. 2000;232:515–29.

  24. 24.

    The longitudinal assessment of bariatric surgery consortium. Perioperative safety in the longitudinal assessment of bariatric surgery. NEJM. 2009;361:445–54.

  25. 25.

    Finks JF, Kole KL, Yenumula PR, et al. Predicting risk for serious complications with bariatric surgery: results from the Michigan Bariatric Surgery Collaborative. Ann Surg. 2011;254:633–40.

  26. 26.

    Lee WJ, Wang W, Lee YC, et al. Laparoscopic mini-gastric bypass: experience with tailored bypass limb according to body weight. Obes Surg. 2008;18:294–9.

  27. 27.

    Higa K, Boone K, Ho T, et al. Laparoscopic Roux-en-Y gastric bypass for morbid obesity. Arch Surg. 2000;135:1029–34.

  28. 28.

    Brolin RE, Kenler HA, Gorman JH, et al. Long-limb gastric bypass in the superobese: a prospective randomized study. Ann Surg. 1992;215:387–95.

  29. 29.

    Kalfarentzos F, Skroubis G, Karamanakos S, et al. Biliopancreatic diversion with Roux-en-Y gastric bypass and long limbs: advances in surgical treatment for super-obesity. Obes Surg. 2011;21:1849–58.

  30. 30.

    Lee WJ, Ser KH, Chen SC, et al. Revision surgery for laparoscopic mini-gastric bypass. Surg Obes Relat Dis. 2011;7:486–92.

  31. 31.

    Mason EF, Ito C. Gastric bypass in obesity. Surg Clin N Am. 1967;47:1345–52.

  32. 32.

    Griffen WO, Young VL, Stevenson CC. A prospective comparison of gastric and jejunoileal bypass procedures for morbid obesity. Ann Surg. 1977;186:500–9.

  33. 33.

    Schafer LW, Larson DE, Melton III LJ, et al. The risk of gastric carcinoma after surgical treatment for benign ulcer disease: a population-based study in Olmsted County, Minnesota. N Engl J Med. 1983;309:1210–3.

  34. 34.

    Hasson LE, Nyren O, Hsing AW, et al. The risk of stomach cancer in patients with gastric and duodenal ulcer disease. N Engl J Med. 1996;335:242–9.

  35. 35.

    McCarthy HB, Rucker Jr RD, Chan EK, et al. Gastritis after gastric bypass surgery. Surgery. 1985;98:68–71.

  36. 36.

    Csendes A, Burgos AM, Smok G, et al. Latest results (12–21 years) of a prospective randomized study comparing Billroth II and Roux-en-Y anastomosis after a partial gastrectomy plus vagotomy in patients with duodenal ulcers. Ann Surg. 2009;249:189–94.

  37. 37.

    Paroz A, Calmes JM, Giusti V, et al. Internal hernia after laparoscopic Roux-en-Y gastric bypass for morbid obesity: a continuous challenge in bariatric surgery. Obes Surg. 2006;16:1482–7.

Download references

Conflict of Interest

All contributing authors declare that they have no conflicts of interest.

Author information

Correspondence to Wei-Jei Lee.

Rights and permissions

Reprints and Permissions

About this article

Cite this article

Lee, W., Ser, K., Lee, Y. et al. Laparoscopic Roux-en-Y Vs. Mini-gastric Bypass for the Treatment of Morbid Obesity: a 10-Year Experience. OBES SURG 22, 1827–1834 (2012).

Download citation


  • Laparoscopic Roux-en-Y gastric bypass (LRYGB)
  • Laparoscopic mini-gastric bypass (LMGB)
  • Morbid obesity