1. It is technically a more complex operation than the AGB or LSG and potentially could result in greater complication rates.
2. It can lead to long-term vitamin/mineral deficiencies, particularly deficits in vitamin B12, iron, calcium, and folate.
3. Generally has a longer hospital stay than the AGB.
4. Requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up compliance.