Since Rutledge developed single anastomosis gastric bypass in 1990, it has been popularized by surgeons in Europe as procedure of choice in the morbidly obese. It involves creating gastric pouch of 12 cm and antecolic loop gastroenterostomy 200 cm distal to the ligament of Treitz. It has comparable excess body weight loss rate to Roux-en-Y gastric bypass, and safety profile is better. This review summarized technical details and key points in performing safe procedure and outlined results of key, high volume series in terms of outcome and technical feasibility.

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