One Anastomosis Gastric Bypass (Mini Gastric Bypass)

Also Known as Single Anastomosis Gastric Bypass

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One anastomosis gastric bypass, also known as mini gastric bypass, is a safe, relatively new procedure in the U.S. that has been recommended by the American Society for Metabolic and Bariatric Surgery since 2022. While few U.S. surgeons are trained to perform it, Duke weight loss surgeons are experienced with the one anastomosis gastric bypass. It is simpler than traditional gastric bypass, has fewer complications, requires shorter hospital stays, and achieves excellent weight loss outcomes. While some insurance companies do not cover this procedure, it is covered by Blue Cross and Blue Shield of North Carolina.

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What Is One Anastomosis Gastric Bypass (Mini Gastric Bypass)?

The stomach is cut and divided into two sections. The new, smaller stomach is shaped like a long tube. The small intestine is measured down from the stomach, a loop is formed, and the top of the loop is connected to the stomach. This connection of two tubular parts that typically do not attach is called one anastomosis. As a result of the procedure, food no longer passes through the larger portion of the stomach and part of the small intestine.

How the One Anastomosis Gastric Bypass Helps You Lose Weight
The mini gastric bypass is considered a metabolic procedure because it changes how your body processes food. It works in three ways.

  • The smaller, newly created stomach holds less food, which means fewer calories are ingested.
  • Up to seven feet of the small intestine is bypassed, which results in the digestion of less food.
  • The altered food pathway changes the levels of gastrointestinal hormones that decrease hunger, increase fullness, and allow the body to reach and maintain a healthy weight. This often results in the improvement of adult-onset diabetes even before weight loss occurs.
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Mini Gastric Bypass Advantages

Safe, Effective Weight Loss Surgery
According to a 2022 study, people who underwent one anastomosis gastric bypass had a lower complication rate and shorter hospitalization stay when compared to Roux-en-Y. It had a complication rate and hospitalization length similar to sleeve gastrectomy.

Expected Weight Loss from Mini Gastric Bypass
A 2020 study reported that the average person experienced up to 73% excess weight loss compared to 60% for Roux-en-Y after five years. Some studies have demonstrated superior weight loss with one anastomosis gastric bypass compared with gastric sleeve, while others report similar weight loss.

Improvement of Obesity-Related Conditions
The 2020 study found that the average person experiences improvement in obesity-associated conditions, including diabetes, insulin resistance, high cholesterol, hypertension, liver disease, and sleep apnea. Improvements are also seen in osteoarthritis and breathing problems.

Lower Complication Rates
Because only one anastomosis, or connection between the stomach and intestine, is made, there is less chance for complications to occur.

Lower Ulcer Risk
Bile acid now flows from the stomach and acts as a protective coating for the lining of the small intestine. This reduces the risk of ulcers.

Dumping Syndrome
While some consider dumping syndrome a disadvantage, it can be beneficial in helping people avoid triggering foods that are high in sugar and carbohydrates. When dumping occurs, it’s temporary and unpleasant and causes bloating, abdominal pain, nausea, diarrhea, sweating, and facial flushing. However, dumping syndrome also changes cravings within the brain and helps you follow dietary guidelines.

Less Risk of Leaks, Bowel Obstruction, and Hernia
Because there is only one small intestine connection, there are fewer locations for leaks to occur. Internal hernias and small bowel obstruction are uncommon complications.

It’s Reversible
It is possible to return your anatomy to normal because nothing is removed.

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Attend your pre-surgical evaluation, all appointments, and monthly support meetings near where you work or live. Attend a free information session online so you can learn more about obesity and weight loss surgery.

Mini Gastric Bypass Disadvantages

Limited Insurance Coverage and Surgical Experience
While common outside the United States, it’s only recently approved as a standard procedure by the American Society for Metabolic and Bariatric Surgery. As a result, most U.S. surgeons have very little experience with this procedure. Because of this, many insurance plans do not cover this procedure. Duke weight loss surgeons are experienced in performing the procedure. Blue Cross and Blue Shield of North Carolina do cover this procedure.

Higher Rates of Vitamin Deficiencies and Malnutrition
Studies show nutritional deficiencies are more likely to occur following one anastomosis gastric bypass than other bariatric procedures. Nutritional recommendations and vitamin supplements are needed to reduce this risk.

Moderate Risk of Bile Reflux and Potential Consequences
The bile that protects the small intestine from developing ulcers can also back up into the stomach. This is called biliary reflux and has been reported in .9% to 4% of patients. This may increase risk for more serious concerns such as stomach and esophageal cancers. Regular endoscopy is recommended to detect Barrett’s esophagus and other esophageal diseases.

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Fill out our application if you are interested in starting the weight loss surgery process. Once you've submitted the application, we will call you to schedule your first appointment.

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Bariatric Center of Excellence

Duke Regional Hospital is accredited by the American Society for Metabolic and Bariatric Surgery for its high standards of care in weight loss surgery. 

This page was medically reviewed on 11/17/2023 by