In gastric bypass surgeries, a large part of the stomach is bypassed and a small volume (approximately 30-50 cc) stomach section is prepared and sewn to the small intestines.
In this surgery, it is aimed both to reduce the volume of the stomach, as in other obesity surgeries, and to disable a part of the intestines so that some of the food consumed is excreted without being absorbed. In this way, patients not only get full with less food, but also some of the food they take is absorbed.
How is Gastric Bypass Performed?
Like other obesity surgeries, gastric bypass surgery is usually performed laparoscopically. The surgery is performed through small incisions in the abdomen. Robotic surgery method is also used for gastric bypass surgeries.
After surgery, patients can easily feel satiety with small amounts of food intake and after a while this satiety turns into loss of appetite.
Total food intake is significantly reduced. Due to the reduced size of the newly created stomach and reduced food absorption, it is necessary to follow the instructions of the surgeon and dieticians for the use of necessary vitamin and mineral supplements.
Thus, the patient can lose weight without losing vitamins and minerals.
Who is a Candidate for Gastric Bypass?
Morbidly obese patients with a body mass index-body mass index (BMI-BMI) above 40 are candidates for gastric bypass. Gastric bypass is preferred over gastric band and sleeve gastrectomy, especially in obese patients with comorbidities such as type 2 diabetes, hypertension and high cholesterol levels. It may also be preferred in super obese patients with a BMI ≥ 50.
Obese patients with a BMI between 35-40 are candidates for gastric bypass if they have comorbidities such as obesity-related diabetes, high blood pressure, high cholesterol, etc.
Gastric bypass surgery has many risks. Some of these risks are very serious. You should ask your doctor for detailed information about them.
The main risks related to surgery and anesthesia are
- Allergic reactions to medicines
- Embolism: blood clots that can form in the legs can travel to the lungs.
- Breathing difficulties
- Heart attack (during or after surgery)
- Infection: at the site of surgery, in the lungs (pneumonia), bladder or kidneys
- Leakage at the site of gastric and intestinal anastomosis
- Small bowel obstruction
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Benefits of Gastric Bypass
Most people lose 10 to 15 pounds in the first month after surgery. The rate of weight loss will decrease over time. The success rate for losing excess weight after gastric bypass is higher than sleeve gastrectomy. In both methods, food intake is limited. In gastric bypass, food absorption is additionally reduced. Therefore, it is relatively superior to sleeve gastrectomy in the loss of excess weight.
Within 1 year after surgery, 75% of excess weight is lost. Loss of excess weight reaches 80-90% in the 2nd year. With the loss of excess weight, there is a significant improvement in the diseases accompanying obesity. The person’s self-confidence returns. In addition, with a significant reduction in the load on the knees and lower back, most of the knee and lower back pain disappears spontaneously.
|OBESITY-RELATED DISEASE||IMPROVEMENT RATE (%)|
|Gastroesophageal reflux disease (GERD)||90|
|High cholesterol level||94|
|Obstructive sleep apnea||75|
|Osteoarthritis of the knee and foot joints||85|
|Type 2 diabetes||70-82|
Bypass surgery alone is not the only sufficient solution for weight loss. Fewer calories can be taken in 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 sleeve gastrectomy. Vitamin and mineral deficiency is seen in 10-15%. When vitamin and mineral deficiency is detected in periodic controls, the deficient vitamin and mineral should be replaced.
Anemia, vitamin/mineral deficiency, protein malnutrition, transient hair loss:
- Deactivation of the duodenum and the first part of the small intestine leads to decreased absorption of iron and calcium. This may predispose to iron deficiency anemia.
- Reduced iron absorption can cause severe iron deficiency anemia in female patients with excessive menstrual or hemorrhoid bleeding.
- Women are already at risk of osteoporosis, especially after menopause. Reduced calcium absorption can cause overt osteoporosis
- Chronic anemia can occur due to vitamin B12 deficiency. The problem is usually treated with vitamin B12 pills or injections.
- This condition, known as “dumping syndrome”, can occur as a result of rapid emptying of stomach contents into the small intestine. It is triggered by consuming too much sugar or sweet, large amounts of food.
- Although not considered a serious risk to overall health, it can sometimes be extremely uncomfortable and can cause nausea, weakness, sweating, fainting, etc., after a meal. Some patients cannot tolerate sweets after surgery.
Gallstones may develop following rapid weight loss in patients.