In the world of mini gastric bypass surgery, one name stands tall—Dr. Robert Rutledge, the visionary who created and advanced the procedure that’s now transforming lives around the globe. In a heartfelt tribute, Dr. David Hargroder, one of America’s leading mini gastric bypass surgeons, reflected on his personal journey with Dr. Rutledge and the remarkable contributions this pioneer made to bariatric surgery.
The story begins in the early 2000s, when Dr. Hargroder first encountered a post-surgery patient in Missouri. The patient’s original procedure had been done in North Carolina by none other than Dr. Rutledge. What followed was a phone call that not only helped save a patient—it also set in motion Dr. Hargroder’s own transformation into a bariatric surgeon.
Dr. Rutledge, already a skilled trauma and general surgeon, had developed the mini gastric bypass (MGB) in 1997 after recognizing ways to simplify the complex Roux-en-Y surgery. His method, born from necessity and shaped by innovation, used a long, narrow stomach pouch and a simplified connection of the small bowel, resulting in faster recovery times, fewer complications, and incredible weight loss outcomes.
Despite initial skepticism from the American surgical community, Dr. Rutledge persisted. He shared his data with transparency, offered open challenges to fellow surgeons, and welcomed others—like Dr. Hargroder—into his operating rooms to learn firsthand. Many criticized his methods, especially his groundbreaking use of the internet and email to communicate with patients, but time has since validated his visionary approach.
Dr. Hargroder’s own MGB journey took off when Dr. Rutledge received a Missouri license to mentor him side-by-side. From this partnership blossomed a career that now defines one of the best mini gastric bypass programs in Missouri, offering quick recovery weight loss surgery, affordable self-pay bariatric options, and life-changing results for patients across the U.S.
Today, Dr. Rutledge’s influence lives on through the thousands of successful surgeries performed by his students, and especially through the continuing efforts of Dr. Hargroder and his team. While the medical establishment may have been slow to embrace the bariatric surgery options Rutledge pioneered, the results speak for themselves.
As we reflect on his life and contributions, we remember not just a skilled surgeon, but a relentless innovator who dared to challenge the norm for the sake of better patient care. His legacy will endure in every life changed by the mini gastric bypass.
If you’re considering weight loss surgery in Missouri, or want to know more about your bariatric options, schedule a consultation with Dr. Hargroder and see how Dr. Rutledge’s legacy continues to impact lives today.
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Video Transcript: "Well, hello, and welcome. I'm doctor David Hargroeder, and you normally hear me on these Tuesday evenings with miss Carla Hueventhal, my patient care coordinator, as we talk about various topics regarding the mini gastric bypass. But today, I wanted to do something a little bit different. Today, I wanna take some time to just remember the great man who was doctor Robert Rutledge. Doctor Rutledge, the creator of the mini gastric bypass, was truly a man that was ahead of his time.
When I first met doctor Rutledge in person, it was around 02/2001, but I had actually met him over the phone a year or two earlier, when I had a patient of his that, had developed a complication, had a an ulcer, a marginal ulcer from their, gastric bypass. The patient, showed up in our emergency room with belly pain. She had the name of her doctor. She had the personal cell phone number of her doctor that had done her surgery because as a kidney transplant surgeon, I wasn't aware of this relatively new procedure called the mini gastric bypass. And so, I called doctor Rutledge on the phone.
I told him I had one of his patients that he had operated on a year or so earlier in the emergency room of my hospital here in Missouri. Of course, he was he had operated on this patient in North Carolina. But he was very matter of fact, he said, yeah. He said it's probably a marginal ulcer. This is probably what you're gonna find, and if you'll just put a couple of stitches in it, she should do just fine.
And sure enough, that's exactly what I did. So it was that phone call and that patient that connected me to doctor Rutledge. Hadn't given it another thought until they ended up closing down our transplant program, and I was looking for something else to do. And I thought about bariatric surgery. Weight loss surgery seemed to be the reasonable thing to do.
And I actually went and took a couple of courses on the and some of these other courses that most other surgeons were doing. But then I remember doctor Rutledge, and I called him up and I said, I would like to learn more about your procedure, this mini gastric bypass procedure. And keep in mind, this is back in about the year February or so. This was early, early on during the, time of the Internet. We we all had, you know, our AOL accounts and email accounts, but, the Internet as we know it today was really nonexistent.
And one of the things that, doctor Rutledge was both known for and then unfairly vilified for was his use of the Internet. And, again, it's like I said, why I say doctor Rutledge is a man so far ahead of his time. He started doing this mini gastric bypass in 1997. And keep in mind also that he was already an accomplished Roux en Y surgeon. He was an accomplished open Roux en Y surgeon.
He was also one of the first surgeons in the state of North Carolina to perform the laparoscopic Roux en Y. And if you hear doctor Rutledge tell the story about how he became a, a bariatric surgeon, you know, it was it was kind of an amusing story because he was he was at this hospital, particular hospital. I can't remember if it was at Duke or if it was at University of North Carolina. And then at one of those hospitals where he was the he was their trauma surgeon and general surgeon, and the chairman of the department had called him in one day and told him that he needed him to start doing bariatric surgery, and that's how he became a bariatric surgeon. But he did so much in the way of innovation.
You know, even today in the state of Missouri, the trauma registry, the computer program we use to keep track of all of our trauma data was actually a program written by doctor Rutledge. So doctor Rutledge's computer savviness was well known even outside of the specialty of general surgery. But he was a general surgeon. He had started doing this bariatric surgery, and and then he developed this idea of, hey. I've been doing this Roux en Y surgery, which is kind of a complicated configuration of how we have to do that, how we have to put the bowel back together and everything.
And so he came up with a new technique, and it was really inspired by a night of trauma call where he, had a gunshot wound to the abdomen come in from a, gunshot, from a a drug deal that had gone bad. Three fifty seven Magnum, right right to the gut. And as a trauma surgeon, he rushed the patient to the Operating Room, stopped whatever bleeding there was and assessed the damage and determined that there was an injury to the pancreas and to the duodenum. And in order to remedy that problem, he had to bypass those injured areas and he did so by simply bringing a loop of jejunum, a loop of small bowel up to the stomach. And the following morning, he actually had a, procedure scheduled for, a Roux en Y gastric bypass, but it happened to be on a friend of his, somebody that he knew, someone that he worked with in the operating room.
And so he approached this patient and said, hey. I've got this crazy idea. Instead of doing a classic Roux en Y gastric bypass, how about I simply bring up a a loop of bowel like I did on this trauma patient last night? I think it'll be a lot faster, quicker, easier. The patient was agreeable, and the first mini gastric bypass was born, and that was in 1997.
And then it was in the year February that doctor Rutledge presented the results of his first twelve hundred cases that he had done. And he did so at a meeting in Las Vegas of the American Society of Bariatric Surgeons. And it was at that meeting that the surgeons that heard his presentation lined up, literally lined up at the microphone to argue and debate his results because nobody believed that his results could possibly be as good as he was stating that they were. Nobody came out and called him a liar, but that's certainly what they were alluding to. And most of the sentiment and most of the attitude was, this is impossible.
You can't have this good of results with this operation because this operation has been tried before. And of course, what they were referring to was the old Mason procedure, a procedure developed by doctor Ed Mason back in the early fifties, which was a loop bypass with one important difference, and that was the way doctor Mason created his stomach pouch was different than the way doctor Rutledge created his stomach pouch. Doctor Mason created his stomach pouch. It's a little walnut sized stomach high up by the esophagus, much like the Roux en Y is today. And doctor Rutledge realized that that was a mistake.
It needed to be a long skinny stomach along the lesser curve and that's what he created. And in so doing, basically eliminated the problems that doctor Mason had faced with his earlier operation that ultimately led to doctor Mason abandoning his operation in the fifties. So surgeons of the early two thousands could not get over this couldn't couldn't how do I how do I put it? You know, they they couldn't get past the changes. They couldn't acknowledge the changes or recognize that the changes that doctor Rutledge had created were small but powerful changes.
Little tweaks is all it was. He instead of having the stomach high up by the esophagus, he made it long and skinny. That took care of the reflux issues that patients complained about. In addition, instead of that loop being way up drug way up to the near the esophagus, which created a lot of tension, making for a tenuous anastomosis. Now with this long skinny by stomach, you could connect that loop way down low under no tension at all.
And so these two simple tweaks to an old forty year old operation changed the game and made this a spectacularly successful and safe and effective operation for weight loss. Now I, having stopped doing transplants, decided I wanted to learn weight loss surgery. And so I reached out to doctor Rutledge in around February, '2 thousand '1, and, I missed that meeting in February. I wish I could have been there, to hear the response from all the surgeons who were arguing with him. That meeting actually, I think, was in Washington, DC.
The following year, the meeting was in Las Vegas, and I was able to go to that meeting. And, again, I watched doctor Rutledge give a presentation, and, I watched him invite other surgeons. Hey. Look. If you don't like my data, if you don't think my data is accurate, I've got a great idea.
We're all scientists here. Why don't I take a hundred of my patients, and let's take a hundred of your patients, and let's write a paper together? Like, let's let's write a paper over a hundred Roux en Y's versus a hundred MGBs. Never got any takers. Never got any takers.
But even back then, back in the early two thousands, doctor Rutledge was communicating with all of his patients through email. He was sending them home with a little thumb drive that had their operative note on it, along with the patient manual and some other things. He had patients coming from all across the country because he did a lot of his work Internet based. He was actually condemned, if you will, for his Internet use as though it were a bad thing, as though he were some sort of traveling surgeon, you know, not, close to home taking care of his patients. And he actually did get, some complaints filed against him in the professional organizations because of his use of the Internet and email, which, again, when we look today at where we are and we see that, you know, every doctor in every modern practice today and especially post COVID is using the Internet either to keep track of their patients through their medical records communication or email or what have you.
So, again, doctor Rutledge, way ahead of his time. When I expressed an interest in, learning this mini gastric bypass, doctor Rutledge couldn't have been more gracious. He invited me up to North Carolina to watch him perform his operation. And, of course, I took him up on that offer without any hesitation. And it was interesting because I had just finished a course on the Roux en Y, that I had done in Dallas.
And, I mean, they made a big production out of it. We I got to watch a a surgery, and there were, like, two or three surgeons in the in the Operating Room, plus the anesthesiologist and two or three assistants and took two or two and a half hours to finish the whole operation. You know? So I go up to, North Carolina to this little community hospital where doctor Rutledge with one assistant and one nurse anesthetist completed five mini gastric bypass before noon. And, it was just truly amazing to watch.
His I mean, his skill, how smooth everything went. And then I stayed overnight, and the next day went to and rounded with him on everybody. And all these patients were walking the halls and ready to go home when most patients having weight loss surgery at the time were having open procedures. And even those that were having laparoscopic procedures, they were, you know, two, three, four hour long operations with a week long stay in the hospital and three or four days in the ICU. And here, doctor Rutledge was doing this thirty, forty minute operation, sending patients home the next day.
And they were doing great, and yet the medical community was all critical of him because they just thought he was doing a terrible operation and a terrible disservice to all of their patient all of his patients. And despite doctor Rutledge's efforts to try and teach this wonderful operations to surgeons around the country, other than myself and three or four other open minded, interested individuals who took the time to look at the data and to learn the operation. Other than myself, doctor Cesar Pragley down in Orlando area, another couple of surgeons, in, the, High Point, North Carolina area. And now there's doctor Billy in Encino, California, but even he, came about not all that long ago. So for almost twenty years, you know, it was me and one or two other surgeons doing this operation around the country, and the way doctor Rutledge did it was also brilliant.
I called him up and said I was interested in learning his operation. Now for most surgeons, the way you would learn a new operation is you either have to spend a whole lot of money and go and take a course and learn it or go do a residency or a fellowship program. But what doctor Rutledge did was he kinda took me under his wing, and he actually got his Missouri medical license. And he got his credentials at the hospital that I was at, so I didn't have to travel to him. He traveled to me.
And since he had patients that came from all over the country, he just redirected his patients from his hospital in North Carolina to our hospital in Joplin. And for about six months, he and I operated together side by side until we finally got to a place where I would, call him if I needed him. But, otherwise, he was sitting in the, in the doctor's lounge just kinda waiting on my phone call. And, eventually, after about six months, when he decided that it was time to pass the hat, so to speak, I'll never forget. He he went out and bought a couple of these white felt Stetson hats, and he made a big production around the hospital saying there was a new sheriff in town, that he wasn't gonna be coming around anymore, that I was gonna be, doing these MGBs, on my own.
And, that was a proud moment and a lot of fun. A little bit of silliness, but, we had a lot of fun that day. Doctor Rutledge, you know, tried to spread the word of the MGB around The United States, and The US just wouldn't have any part of it. And so surgeons from around the world started taking an interest. Doctor Kular in India, in particular, was one of the surgeons that took a particular interest, and that's where doctor Rutledge has now spent most of his last days was in India with who became his very dear friend and colleague, doctor Kullar, who's also now a very dear friend of mine.
And I appreciate all that he's done to promote and advance the field of, bariatrics through the mini gastric bypass. A number of other surgeons from around the world also embrace doctor Rutledge's procedure. Surgeons in Germany, in Italy, in Greece, in Australia, in Mexico, South America. Doctor Rutledge traveled the world because he couldn't travel The United States. There were no surgeons in The US that were interested in learning.
Matter of fact, he sent me, to teach a few surgeons that had expressed an interest, but none of those surgeons really ever took off. And so the program was always been limited to just a few programs that we've had here in The US between myself, doctor Pragley, and and, doctor Rutledge. But for the last ten or fifteen years, Rutledge has sort of been back and forth between The United States and India, which has really become his second home and where his funeral services and burial will be. I think the world has lost a really great man, a great surgeon, an innovator who was really ahead of his time. He's gonna be greatly missed by me.
I know he certainly did change my life for the better in learning this operation. It it's been so much, of a fulfilling practice that I've had, when you compare it to just the run of the mill, gallbladders and hernias, etcetera. Even the kidney transplants that I did back in the day, you have grateful patients and you keep track of them, but, you know, they're still a little sick. They're always worried about rejection, etcetera. Whereas the MGB patients, their lives are just changed so profoundly, that it it really is an honor and a privilege to have been a student of doctor Rutledge, who I believe is, is gonna go down, in the history of, weight loss surgery, bariatric.
When the bariatric history books are are written, I think, doctor Rutledge is gonna be one of the greats. And, I'm just happy to be one of the coattail hangers riding riding along for the for the satisfaction and enjoyment of it. I hope you all, appreciate the little bit of background information I've given on doctor Rutledge, and, feel free to pass this along to any of his patients that might enjoy hearing it. Thank you all for listening. We'll be back again with Carla next Tuesday, and, I'm sure she'll have an interesting topic for us.
Thank you. Good night."