Gastric bypass is a bariatric surgery technique included within the mixed methods because it is restrictive and selectively malabsorptive.
It reduces the size of the stomach. And it alters the digestive cycle, so the intestine absorbs less fat and sugar. This technique achieves very satisfactory results in weight loss and improving diabetes, hypertension and other diseases associated with obesity.
Through this technique and laparoscopically, the surgeon cuts the stomach leaving a small cavity of between 15 and 30 ml (known as a reservoir or pouch in English) while the rest is isolated so that food does not pass through. Another incision in the small intestine allows the surgeon to connect it directly to the newly created small stomach.
“gastric bypass is a bariatric surgery that requires general anaesthesia but is minimally invasive and has a postoperative period that is not very painful.”
In addition, with the reduction of the stomach, a significant decrease in the production of ghrelin, the hunger hormone, is achieved. Thus, by reducing the appetite and reducing the absorption of calories, the patient loses weight effectively and has more options to maintain it in the long term.
This surgery requires general anaesthesia. The effect of this lasts about two to three hours. The intervention is done laparoscopically. This surgery requires five small incisions in the patient’s abdomen. It is a minimally invasive, almost painless technique with a fast recovery.
After discharge, the patient must follow a controlled and progressive diet that begins with Phase 1: Liquid food. In addition, he must carry out a physical activity plan that will go from less to more until his final recovery.
Types Of Gastric Bypass
The most common gastric bypass is Roux-en-Y, and it consists, as we have explained, of dividing the intestine and connecting it to the new gastric reservoir. In this way, we diversify the digestive cycle by creating two circuits or pathways with the shape of a Greek Y. As seen in the image, the food does not pass through the rest of the stomach. Instead, it “bypasses” it as if it were a “highway or ring road”. Instead, it passes quickly to the intestine without passing through the stomach and stimulating the pancreas (where the origin of diabetes lies). The secretions of the liver, bile duct and pancreas necessary for digestion pass through the other route when they join with the food below.
Finally, gastric bypass can be customised to the patient’s characteristics (degree of obesity, risk factors, etc.). This achieves the desired effects: reduce weight, improve diabetes, lower cholesterol-triglyceride levels, etc. Depending on these technical modifications, it receives different names: distal bypass, single anastomosis bypass, BAGUA, etc. But they all have the same base and the same operation.
Which Patients Is Suitable For A Gastric Bypass?
The patient who can undergo a gastric bypass is the same as the rest of the candidates for bariatric surgery. Patients aged between 18 and 65 and with a BMI greater than 40.
However, gastric bypass is a technique especially indicated for patients with a tendency to eat or snack between meals, who are considered “gluttons” and have a compulsive relationship with food and cannot control their impulses.
Pros And Cons Of Gastric Bypass
This bariatric surgery technique has pros and cons compared to others. We are going to list some of them.
- With gastric bypass, the average weight loss is much higher than in other procedures (between 60% and 70% of excess weight), such as gastric banding or vertical gastrectomy (gastric sleeve). It is also much faster if you follow the medical instructions on a diet.
- Obesity-related diseases, such as type 2 diabetes, hypertension, gastroesophageal reflux, or sleep apnea, can begin to improve even before weight loss.
- Bypass is a reversible procedure. That is, it can be reoperated to return to the initial state. This does not happen with the gastric sleeve, which is irreversible since a part of the stomach is removed).
- Patients who undergo gastric bypass can significantly improve their quality of life and general health.
- The surgery requires more experience and technical skill than gastric sleeve or other procedures. However, the postoperative period is similar to other systems, being a process with little pain and simplicity.
- Being a restrictive and malabsorptive technique, the ability to absorb nutrients such as iron or some vitamins is selectively reduced. Because of this, the patient must take vitamin supplements for life.
- The patient must follow a diet low in sugar, simple carbohydrates, or starch. This is because these foods can give you dumping syndrome (sudden drops in blood sugar that cause dizziness and discomfort).
- Before any bariatric surgery, a detailed psychological evaluation must be carried out. It is essential to detect if there is an anxiety disorder that the patient compensates with binge eating. If left untreated, the patient may develop a transfer of this “food addiction” to something else, such as alcohol or drugs.
Finally, the important thing is that you put yourself in the hands of a team of specialists with a lot of experiences, such as ObesiMad and D-Medical. They will know which technique best suits your needs and will help and accompany you throughout the process.