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WHAT IS GASTRIC BYPASS AND HOW IT IS DONE ?
Roux-en-y gastric bypass or Mini ‘gastric bypass’ requires change both on stomach and small intestine. In this procedure, the upper part of stomach is stapled and then a small gastric pouch ,whose size is approxiamtely like an egg, is created with sticking intestines into a part which is called Roux.
Gastric bypass is a combined procedure which has qualifications as both restrictor and absorption decrease. The first stage of the operation includes dividing the stomach into two with using staples to create a small space on the upper side of the stomach to make stomach pouch (20-25 ml). And thus , feeling of fullness is provided with small amount of nutrient. This volume nearly equals to half or quarter size of a bowl of soup volume. Eating less constantly but also having fullness feeling lead to weight loss.
The second stage of operation includes bypass which is called bridging. Therefore , the remaining part of stomach and some amount of small intestine are bypassed. This part continues to transfer enzymes like stomach acid , bile acid and pancreas water which play a role on digestion. The stomach pouch which is created anastomosed into 150-200 cm small intestine segment.
Nutrients reach into the forward part of intestines without passing through remaining part of stomach and 2m part of small intestine.
One of the effect of this operation is that there is no absorption on the 2m section of small intestine because of not dealing with digestion liquids.
The basic metabolic power which is provided with operation is completely different. Briefly, From the different parts of human digestion system excretes different hormonal substances. Some hormones which are called ‘incretin’ are excreted from small intestine and these are hormones which shows parallel effect like insulin(balances blood sugar) and they strengthen insulin. Substances which are called anorexigenic hormones decrease appetite and create fullness are excreted from this part.
As it is seen the volume of stomach minimized in both Gastric Sleeve and Gastric Bypass surgery . The biggest difference between these two procedures is; In Gastric Bypass surgery a piece of small intestine is removed and sticked into stomach. More organ anatomy is done. Gastric Bypass can be done with laparoscopic or open surgery. Operation length is between 1 and 3 hours.
Hospitals stay period is similar but when it is compared with Gastric Sleeve generally it has longer recovery process. Generally, most of the people after Gastric Sleeve completely recover within 6 weeks or 2 months. However, some people can recover %80 and complete recovery can pass 3 months with Gastric Bypass.
WHAT ARE THE COMPLICATIONS OF GASTRIC BYPASS ?
Complications which will be possible after Gastric Bypass are similar to complications after Gastric Sleeve. Generally, classic bariatric surgery complication rate is nearly %4. Some research have shown that complication rates connected to Gastric Sleeve is %3,7 on the other hand complication rates connected to Gastric Bypass is %4,3.
Let’s compare complication types which are observed after these procedures. General complications which can occur after both Gastric Sleeve and Gastric Bypass :
- Bleeding
- Blood Cloths
- Pneumonia
- Gallbladder and Gallstones inflammation
- Hernia
- Nutrient deficiency
- Nausea , vomiting or diarrhea which accompanies with sweating that is called dumping syndrome
- Leakage
There are some specific complications which are specific into both operation types. Complications that are specific to Gastric Sleeve
- Imposthumation
- Tightness
- Esophageal Reflux
- Complications that are specific to Gastric Bypass
- Intestine congestion
- Digestion system bleeding
- Alcohol tolerance
- Stomach Ulcer
Both of the procedures require vital life style changes. When life style changes are not followed , physical consequences or negative side effects or symptoms occurrence is high. One of the example is Dumping syndrome. Dumping syndrome is group of syndrome which may appear after eating something on people who had bariatric surgery. %85 of people who had obesity surgery have dumping syndrome . When some specific food and beverages are observed , Dumping syndrome rate shows difference between two operation types. %27 of Patients who had Gastric Sleeve and %44 of patients who had Gastric Bypass declared that they had at least one symptom was observed which was connected to dumping syndrome. After alcohol consumption , %14,5 of patients who had Gastric Sleeve and %17,3 of patients who had Gastric Bypass had a kind of dumping syndrome.
When Dumping syndrome is generally observed , Gastric Sleeve has similar statistics but Gastric Bypass has more risk of dumping syndrome when some specific food is consumed. Following Gastric Bypass there is high risk of food intolerance , Gastric Sleeve is commonly associated with good tolerance into food and better life conditions in long term.
It should be bear in mind that the most important thing is to follow regulations of some specific diet and life style changes in order to lose weight successfully after operations.
