Same bypass results. Half an hour less in the OR.
One connection, not two. Same weight and diabetes numbers as the traditional bypass — in less OR time (YOMEGA, Lancet 2019).
01 · What it is
The mini-bypass — also known as BAGUA ("Bilbao Anastomosis Gastrica Una Anastomosis") in Spanish or OAGB ("One-Anastomosis Gastric Bypass") in international literature — laparoscopically creates a long, narrow gastric pouch from the lesser curvature of the stomach, anastomosed to a single loop of jejunum (omega loop).
It combines gastric restriction with malabsorption and the same hormonal changes as the traditional bypass. The key difference: a single anastomosis instead of two — a technically less complex configuration with shorter operative time (60–90 minutes vs 90–120 for RYGB, per the YOMEGA randomized trial, Robert et al. Lancet 2019).
IFSO accepts the mini-bypass as a standard bariatric procedure (IFSO Position Statement on OAGB, 2018). Results are comparable to RYGB for weight loss and type 2 diabetes remission. The main clinical concern is bile reflux, which we evaluate case by case before deciding between the two options.
02 · Who it's for
General indications match those for traditional bypass per the 2022 ASMBS/IFSO Guidelines (Eisenberg et al., SOARD) and the IFSO Position Statement on OAGB 2018. Real candidacy depends on your medical history, comorbidities, and willingness to commit to lifelong supplementation.
Class II or III obesity, no comorbidities required, per 2022 ASMBS/IFSO Guidelines. Same BMI indications as Roux-en-Y bypass.
Type 2 diabetes, hypertension, sleep apnea, or other metabolic comorbidities. T2D remission results comparable to RYGB (Mahawar et al. 2018; YOMEGA RCT).
If you're a candidate for traditional bypass but want a technically less complex configuration with shorter operative time — while maintaining equivalent results.
If you have significant gastroesophageal reflux, elevated bile-reflux risk, or prefer the more-studied 10+ year standard configuration, traditional RYGB may be the better option. We talk about that before surgery — not after.
03 · The procedure
Cardiology, anesthesiology, clinical nutrition, and bariatric psychology evaluations. Endocrine and metabolic studies. Specific reflux-risk evaluation before choosing between OAGB and RYGB.
Laparoscopic operation under general anesthesia. Creation of a long, narrow gastric pouch from the lesser curvature, anastomosed to a single loop of jejunum (omega loop). Operative time approximately 60–90 minutes (YOMEGA — Robert et al. Lancet 2019).
1–2 nights in hospital. Early ambulation within 24 hours. Start of supervised clear-liquid diet. Standard pain management and antithrombotic prophylaxis.
If you're from outside Cancún, 3 additional days before flying home. Hotel near the hospital, WhatsApp follow-up, fluid and diet tolerance monitoring.
Progressive advancement over approximately 6 weeks: clear liquids → full liquids → puree → soft solids. Mandatory supplementation with bariatric multivitamin, iron, calcium, vitamin B12, and vitamin D — for life.
In-person or virtual visits at month 1, 3, 6, and 12. Nutritional monitoring with micronutrient labs. Surveillance for bile reflux symptoms. Direct WhatsApp with the surgeon when you need it.
04 · Outcomes
Averages lie in personalized medicine. These are evidence-backed ranges for patients who follow the post-op protocol. Your real outcome we evaluate in consultation.
%EWL at 2 years post-op in the YOMEGA randomized trial (Robert et al. Lancet 2019), comparable to approximately 86% for RYGB in the same cohort.
T2D remission rates comparable to traditional Roux-en-Y bypass (YOMEGA — Robert et al. Lancet 2019; Mahawar et al. 2018; IFSO Position Statement 2018).
Some studies report significant bile reflux in approximately 5–7% of patients, with conversion to Roux-en-Y as management. It's a debated risk we evaluate before choosing between the options.
Sources: Robert et al. (YOMEGA randomized trial, Lancet 2019); IFSO Position Statement on OAGB (2018); Mahawar et al. (systematic review of OAGB, Obesity Surgery 2018); Eisenberg et al. (2022 ASMBS/IFSO Guidelines for MBS Indications, SOARD).
05 · Cost
Each case has a different risk profile, hospital choice, length of stay, and follow-up program. Publishing a single number would be dishonest — it would either undersell complex cases or overprice simple ones.
WhatsApp me your weight, height, and any medical conditions. I respond within 24 hours with a real quote, hospital recommendation, and financing options if you need them.
06 · Mini-Bypass vs Bypass
07 · Frequently asked
Next step
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