BAGUA: The Cutting Edge Technique That’s Revolutionizing Bariatric Surgery in Mexico

Sep 24, 2017 — by Daniel Huacuz, MD

BAGUAIn 1997, Dr. Robert Rutledge demonstrated the first viable surgical application of the technique which would become known as mini gastric-bypass surgery (MGB). Rutledge had developed this method over years spent as an attending surgeon at the University of North Carolina at Chapel Hill, where he was mostly concerned with the treatment of patients suffering from critical trauma.

Rutledge had also kept a close eye on the advanced treatments being offered by the facilities’ bariatric surgery team. He had watched with keen interest as the technical, intensive procedures of the 80’s had given way to the less invasive laparoscopic techniques in the 90’s. However, he noticed that gastric bypass, one of the most popularly performed surgeries remained “pretty demanding”, despite improvements in technology and knowledge – patients were still under the knife for several hours.

Rutledge recognized that complications from the surgery were often a result of the method used to connect the stomach to the lower intestines in gastric bypass. He saw an opportunity to simplify and optimize the procedure by adding a routine technique known as Billroth II Gastro-Jejunostomy. In September of 1997, Rutledge finally got the chance to test his technique with great results, and mini-gastric bypass surgery was born.

Introduction to Mexico

In the ensuing 20 years, the surgery has been performed over 30,000 times and has quickly become one of the most demanded bariatric treatments in the world. All of this has occurred despite the fact that the treatment is currently not covered by most insurance carriers, and many surgeons still don’t know how to perform it.

However, one country where the surgery has found a firm foothold is Mexico. Here, two bariatric surgeons; Miguel A. Carbajo and Enrique Luque-de-León had followed Rutledge’s successes with MGB closely and had decided to try and replicate his results themselves. The two surgeons decided to make some adjustments to Rutledge’s techniques, modifying the original version to counteract the prevalence of acid reflux that was often seen in patients afterwards.

From 2001 to 2005, they performed their adjusted surgery over 200 times, with results so impressive that they decided to adopt it as their primary bariatric surgery. The new technique was named, one-anastomosis gastric bypass, or Bypass Gástrico de Una Anastomosis (BAGUA) in Mexico.

Over time, as researchers have recognized the surgery for its safety, efficiency and effectiveness, publishing their findings in multiple Journals; Mexico has become recognized as one of the originators and primary locations for this cutting edge surgery.

Benefits of BAGUA

BAGUA provides documented results that are very similar to Roux-En-Y gastric bypass. Patients lose about excess weight just as effectively (up to 80%), and experience an alleviation in several obesity related illnesses including, Type II Diabetes, sleep apnea and hypertension at rates actually higher than Roux-En-Y.

The best thing is that BAGUA achieves this long-term effect despite the fact that surgery is far simpler, requiring less operating time and posing far fewer risks of complication. Studies have shown that BAGUA results in fewer issues with instructional obstruction and internal herniation. Costly revisions are also far less likely with this technique, with only 5% of patients requiring further surgeries.

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