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Introduction The field of metabolic and bariatric surgery is rapidly evolving, with innovative techniques improving patient outcomes and transforming lives. At the World Congress of Advanced Laparoscopic Surgery (WALS) 2025, the late Dr. Robert Rutledge, a pioneer in bariatric surgery, is celebrated for his groundbreaking contributions, particularly the Mini-Gastric Bypass (MGB). This article explores the envisioned advancement of the MGB, referred to as "MGB 2," as a next-generation approach to metabolic and bariatric surgery, building on Dr. Rutledge’s legacy. Dr. Robert Rutledge: A Legacy of Innovation Dr. Robert Rutledge, widely regarded as the father of the Mini-Gastric Bypass, revolutionized bariatric surgery with a procedure that is short, simple, and effective. Developed in 1997, the MGB was inspired by Rutledge’s experience as a trauma surgeon treating a gunshot wound, where he performed a Billroth II anastomosis with duodenal exclusion. This led to the creation of the MGB, a laparoscopic procedure that creates a long, narrow gastric pouch along the lesser curvature of the stomach, connected to a loop of the small intestine approximately 180–200 cm from the duodenum. The MGB combines restrictive and malabsorptive mechanisms, offering significant weight loss, resolution of comorbidities, and a low complication rate compared to traditional Roux-en-Y gastric bypass (RYGB). Dr. Rutledge’s work extended beyond the operating room. He was a dedicated educator, sharing his expertise through lectures, publications, and training programs worldwide, particularly in India, where he spent his later years. His contributions to the International Bariatric Club (IBC) and conferences like the MGB-OAGB International Club’s Consensus Conference underscored his commitment to advancing surgical techniques and patient care. The Mini-Gastric Bypass (MGB): A Foundation for Progress The MGB has gained global popularity, with approximately 15.4% of weight-loss surgeries in Asia now utilizing this technique. Its advantages include: Simplicity and Speed: The procedure takes 30–90 minutes and often requires only a 1–2 day hospital stay. Low Risk: The MGB has a lower complication rate than RYGB, with minimal long-term nutritional deficiencies due to its design, which preserves nutrient absorption. Effectiveness: Patients achieve an average weight loss of over 140 pounds within one year, with over 93% success in resolving comorbidities like type 2 diabetes, hypertension, and sleep apnea. Reversibility and Revisability: Unlike other bariatric procedures, the MGB can be easily revised or reversed, offering flexibility for patients. Despite initial skepticism in the United States, the MGB has been validated through controlled prospective trials, demonstrating superior outcomes compared to adjustable gastric banding and RYGB. Its growing adoption worldwide, including in Europe, Asia, and Australia, reflects its efficacy and safety. Conclusion Dr. Robert Rutledge’s Mini-Gastric Bypass transformed bariatric surgery, offering a safer, simpler, and more effective alternative to traditional procedures. At WALS 2025, the concept of MGB 2 builds on his legacy, integrating robotic surgery, personalized planning, endoscopic enhancements, and advanced nutritional strategies to advance the future of metabolic and bariatric surgery. By addressing challenges like standardization and access, MGB 2 has the potential to further improve patient outcomes and expand the reach of bariatric care worldwide. Dr. Rutledge’s vision of excellence, education, and patient-centered care continues to inspire the next generation of surgeons, ensuring his legacy endures. https://www.laparoscopyhospital.com/S... Contact us: World Laparoscopy Hospital Cyber City, Gurugram, NCR Delhi, INDIA Phone/WhatsApp: +919811416838, +919999677788 World Laparoscopy Training Institute Bld. No: 27, DHCC, Dubai, UAE Phone: +971525857874 World Laparoscopy Training Institute 8320 Inv Dr, Tallahassee, Florida, USA Phone: +1 321 250 765