Gastric ByPass

About Gastric ByPass

Gastric bypass surgery has two stages:

• In the first stage of gastric bypass surgery; The stomach shrinks. A small pouch is created by dividing the upper part of the stomach close to the esophagus with a stapler. This pouch is about the size of a tangerine.
• Second stage of gastric bypass surgery; The formed gastric sac is connected to the distal of the small intestine (jejunum) with a small hole. The food will go to the small intestine without passing through the duodenum and the first 100-150 cm of the small intestine. Therefore, less of the food will be absorbed, hence fewer calories will be absorbed.

Gastric bypass can be performed with two techniques, open and laparoscopic. More laparoscopic technique is preferred. And Bariatric istanbul always prefers the laparoscopic method! The advantages of laparoscopy over open surgery are:

• Shorter hospital stay and faster recovery.
• Less pain.
• Smaller scars (4-5 0.5-1 cm incisions) and less risk of hernia or infection.

This surgery is performed under general anesthesia and takes about 2 to 3 hours.

Who is a candidate for Gastric Bypass?

Morbidly obese patients with a body mass index (BMI-BMI) over 38 are candidates for gastric bypass. Gastric bypass is preferred instead of gastric band and sleeve gastrectomy, especially in obese patients with additional diseases such as type 2 diabetes, hypertension and high cholesterol level. In addition, it can be preferred in super obese patients with BMI ≥ 50.

Obese patients with a BMI between 35-40 have obesity-related diabetes, high blood pressure, high cholesterol, etc. If they have concomitant diseases, they are candidates for gastric bypass.

Gastric Bypass Risks

Gastric bypass surgery has many risks. Some of these risks are very serious. Detailed information about this should be obtained from your doctor.

The main risks associated with gastric bypass surgery and anesthesia are:

• Allergic reactions to drugs
• Embolism: blood clots that can form in the legs can travel to the lungs.
• Bleeding
• Breathing difficulties
• Heart attack (during or after surgery)
• Infection: in the surgical site, lung (pneumonia), bladder or kidneys
• Leak at the gastric and intestinal anastomosis site
• Small bowel obstruction

Preparation before Gastric Bypass Surgery

As with other surgical procedures, there are pre-operative preparations that must be done carefully. Your doctor's recommendations for you are usually as follows.

• It is recommended to follow a diet for 1 week before surgery to reduce the fat around the liver.
• Only Liquid diet for 48 hours before surgery.
• In patients with constipation, it is necessary to clean the colon by taking magnesium citrate or Colyte before surgery.
• Discontinue all medications you take unless your doctor advises you to.
• If you are using any herbal medicine and headache or allergy or blood thinning medicine, it should be known before the surgery.
• Gastric endoscopy is usually required before surgery. Gastric hernia, reflux disease, ulcer and tumor should be investigated.
• If you smoke, you should stop smoking a few weeks before the surgery. Smoking slows wound healing. It increases the risk of respiratory failure.

Preoperative blood tests and abdominal ultrasonography are performed. Anesthesiology, cardiology and pulmonology consultations may be required to assess the risk of operation after the examinations are completed. 

Diseases that occur due to obesity and disappear completely or improve considerably with the loss of excess weight.

Heal Features of Gastric ByPass

• Asthma 82%
• Gastroesophageal reflux disease (GERD) 90%
• Hypertension 60-70%
• High cholesterol level 94%
• Obstructive sleep apnea 75%
• Osteoarthritis of the knee and foot joints 85%
• Depression 72%
• Type 2 diabetes 72%

Benefits of Gastric Bypass

Most people lose 10 to 15 pounds the first month after surgery. The rate of weight loss will decrease over time. The success rate of losing excess weight after gastric bypass is higher than sleeve gastrectomy. In both methods, food intake is limited. In addition, food absorption is decreased in gastric bypass. Therefore, it is relatively superior to sleeve gastrectomy in losing excess weight.

75% of excess weight is lost within 1 year after surgery. Loss of excess weight reaches 80-90% in the 2nd year. Along with the loss of excess weight, a significant improvement is observed in diseases accompanying obesity. Self-confidence comes back. In addition, with the significant decrease in the load on the knee and waist, most of the knee and low back pain will go away on its own.

Gastric Bypass surgery alone is not a sufficient solution for weight loss. You can get fewer calories with less food. Calorie expenditure should also be increased. This is possible with exercise. In order to prevent complications in the postoperative period, it is necessary to follow the exercise and nutrition rules given by the doctor and dietitian.

There are also risks (complications) seen in the late period after bariatric surgery. These risks are higher after gastric bypass surgery than after sleeve gastrectomy. Vitamin and mineral deficiency is seen in 10-15%. When vitamin and mineral deficiencies are seen in periodic controls, the vitamin and mineral deficiency should be replaced.