Background and Aim: Obesity is a chronic disease that is increasing in prevalence worldwide. Bariatric surgery could be the definitive clue in many situations. Medical management and follow up of patients who have undergone bariatric surgery is a challenge opportunity due to post operative complications. A new modified intestinal bypass (MIBP) operation was designed to maintain good digestion and selective absorption with less medical and surgical complications. Patients and Methods: We experienced 157 patients medical follow up ; 122 females (78.2%) and 34 males (21.8%) , who have undergone a new modified intestinal bypass (MIBP) surgery ; (Elbanna operation) as well as we evaluated Excessive weight loss (EWL), nutritional supplements, motility disorders, and fatty liver for consecutive 3 years after operation. Conclusion: MIBP surgery (Elbanna operation) solved the medical problem of nutritional deficiency post intestinal bariatric surgeries. Our concept changed from maldigestion and malabsorption to good digestion and selective absorption.