Gastric bypass surgery is one of the oldest operational technique in the history of bariatric surgery.
However, due its effectiveness, it is still the second most frequently used bariatric surgery method.
Previously, it was the most frequently performed obesity surgery. Due to the effectiveness, ease of application and satisfactory results the sleeve gastrectomy has started to be performed more frequently, nonetheless bypass surgeries are still effectively performed in Antalya, Turkey and worldwide. Gastric bypass surgeries are more effective in regulating blood sugar, especially for patients with diabetes type 2. It is also the most commonly used method in revisional surgeries.
The most commonly performed gastric bypass surgeries are:
(One Anastomosis Gastric Bypass) (OAGB)
The purpose of bypass surgeries is mainly to eat less and to reduce calories absorption.
Firstly, a small stomach pouch is created. The small intestine end, which is in Roux-en Y gastric bypass transected from below, is added to the gastric pouch. Mostly used limbs are: an alimentary limb (AL) of 100-150 cm length and a biliopancreatic limb (BPL) of 50 to 120 cm length.
In the Mini Gastric Bypass, the small intestine, which is measured from a distance, is pulled up into the stomach pouch and joined directly. The length of this biliopancreatic limb (BPL) is important on weight loss, comorbidity resolution and long term complications. A 150-cm BPL length is adequate with minimal complications and good results. While, up to 250-cm BPL may be used in case of very long intestinal and super obesity.
As a result, it is aimed to feel full with a small amount of food. In addition, it is aimed to digest and dispose less of the eaten food. The most effective area in intestinal digestion are the first parts of the small intestine. Since the stomach, duodenum and a large part of the small intestine are bypassed, the name of these surgeries has been accepted as gastric bypass.
Since the absorption decreases after bypass surgeries, it is stated that these surgeries are more effective especially for people who consume excessive foods high in sugar. It has also very satisfactory results, especially for patients with type 2 diabetes. The duodenum and the first jejunum parts stimulate insulin during the passage of the food into the small intestine. When this area is bypassed, the need for insulin secreted from the pancreas will decrease. Therefore, if the insulin secreted from the pancreas is sufficient, it is expected that the diabetes will improve after the operation.
Hospital stay and recovery processes of gastric bypass surgeries are similar to Sleeve Gastrectomy. A 3-day stay in the hospital is required.
Although the weight loss rate of these patients is in many publications similar, it is reported that the sleeve gastrectomy surgery is better in some publications, and bypass surgery in the others.
Although the weight loss rates of these patients are similar according to many publications, it is reported sometimes that after gastric sleeve surgery the weigh loss is faster however, according to another statistics, patients after bypass surgery lose weight faster. The important thing is to determine the surgical technique specific to the patient and to apply the surgical approach with maximum safety. Long-term complications are relatively higher in bypass surgeries. These are diarrhea, intermittent abdominal cramps, vitamin losses, mineral deficiencies, eating problems such as dumping syndrome.
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