Same bypass results. Half an hour less in the OR.

Mini-Bypass / BAGUA (OAGB)
in Mexico (Cancún).

One connection, not two. Same weight and diabetes numbers as the traditional bypass — in less OR time (YOMEGA, Lancet 2019).

2,000+ Procedures
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Dr. David Lomelí en quirófano realizando un mini-bypass / BAGUA
In the OR · Hospital Joya, Cancún

01 · What it is

One connection less. The same chemistry.

Diagrama del mini-bypass / BAGUA con asa omega
1 anastomosis (vs 2 in RYGB)

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

Not for everyone. And I tell you in the first consult.

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.

≥35

BMI 35 or higher

Class II or III obesity, no comorbidities required, per 2022 ASMBS/IFSO Guidelines. Same BMI indications as Roux-en-Y bypass.

≥30

BMI 30+ with metabolic disease

Type 2 diabetes, hypertension, sleep apnea, or other metabolic comorbidities. T2D remission results comparable to RYGB (Mahawar et al. 2018; YOMEGA RCT).

RYGB

Bypass candidate who prefers lower complexity

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

From first consult to discharge. What happens, step by step.

60–90 minutes in the OR · 1–2 nights in hospital
01

Pre-operative evaluation

Cardiology, anesthesiology, clinical nutrition, and bariatric psychology evaluations. Endocrine and metabolic studies. Specific reflux-risk evaluation before choosing between OAGB and RYGB.

02

Surgery day

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).

03

Hospital recovery

1–2 nights in hospital. Early ambulation within 24 hours. Start of supervised clear-liquid diet. Standard pain management and antithrombotic prophylaxis.

04

Post-surgical stay

If you're from outside Cancún, 3 additional days before flying home. Hotel near the hospital, WhatsApp follow-up, fluid and diet tolerance monitoring.

05

Dietary protocol

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.

06

12-month follow-up

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

Follow the program, lose the weight. Don't, and you gain it back.

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.

~88%

Excess weight loss at 2 years

%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.

RYGB

Type 2 diabetes remission comparable

T2D remission rates comparable to traditional Roux-en-Y bypass (YOMEGA — Robert et al. Lancet 2019; Mahawar et al. 2018; IFSO Position Statement 2018).

~5–7%

Risk of significant bile reflux

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

I don't publish prices. Here's why.

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.

Get a quote on WhatsApp →

06 · Mini-Bypass vs Bypass

Which one? Depends on what you bring.

Mini-Bypass / BAGUA · This page

When the mini-bypass wins

  • You want bypass-level results with shorter operative time (60–90 min vs 90–120 min).
  • A single anastomosis = technically less complex configuration.
  • You're a bypass candidate who prefers lower technical complexity.
  • Results comparable to RYGB in weight loss and T2D remission (YOMEGA, Lancet 2019).
  • No elevated bile-reflux risk, and willing to commit to lifelong supplementation.
Gastric Bypass (RYGB)

When traditional RYGB wins

  • Diagnosed bile reflux or elevated risk.
  • History of complex previous gastrointestinal surgery.
  • Surgeon preference for Roux-en-Y configuration based on the case.
  • Need for the more-studied standard configuration — broader 10+ year literature.

Ask me about Gastric Bypass on WhatsApp →

07 · Frequently asked

Your questions deserve honest answers.

Yes — same procedure, two names. BAGUA is the Spanish acronym ("Bilbao Anastomosis Gastrica Una Anastomosis"). In international literature it's known as OAGB (One-Anastomosis Gastric Bypass) or mini gastric bypass. Same surgical technique, different naming by region.
Results comparable to traditional bypass. In the YOMEGA randomized trial (Robert et al. Lancet 2019), the mini-bypass achieved approximately 88% of excess weight loss at 2 years versus approximately 86% for RYGB in the same cohort. Your real outcome depends on your starting BMI, adherence to the nutritional protocol, supplementation, and physical activity.
Traditional Roux-en-Y bypass (RYGB) has two anastomoses (Y-shape configuration). The mini-bypass / BAGUA has a single anastomosis (omega loop). This translates to shorter operative time: approximately 60–90 minutes for mini-bypass vs 90–120 minutes for RYGB (YOMEGA — Robert et al. Lancet 2019). Weight loss and diabetes remission outcomes are comparable. The most debated clinical difference is bile-reflux risk in the mini-bypass.
There is debate in the literature. Some studies report significant bile reflux in approximately 5–7% of mini-bypass / OAGB patients, with conversion to Roux-en-Y as management when severe. It's one of the key points we evaluate before deciding between mini-bypass and traditional RYGB in consultation. If you have a history of reflux or esophagitis, RYGB is generally the better option.
Varies by hospital (Joya, Amerimed, or Galenia), length of stay, and follow-up program. I don't publish a single number because it would be dishonest — it would either undersell complex cases or overprice simple ones. WhatsApp me for a real quote within 24 hours, along with financing options if you need them.

Next step

I don't publish prices. So you write me, not a call center.

WhatsApp me your weight, height, and any medical conditions. I respond personally with a procedure quote, hospital recommendation, and financing options if you need them.

Reply within 1 hour · 24/7
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