Mini Gastric Bypass
Among obesity (bariatric) operations, mini gastric bypass is one of the simplest, quickest and most cost-effective to perform. It achieves as much weight loss as other bypass operations. It can help bring under control conditions such as type 2 diabetes, high blood lipids (hyperlipidaemia) and high blood pressure, which are among the main features of metabolic syndrome. The basic principle of the operation is to reduce the volume of the stomach. In addition, the part of the intestine just beyond the stomach outlet, which is responsible for absorption, is bypassed. The bypass is created by connecting the stomach and the small intestine (an anastomosis). By taking this absorptive section of the intestine out of the food pathway, the operation leads to rapid weight loss, helps treat high blood pressure, high cholesterol and diabetes, and also has positive effects in older patients. Mini gastric bypass is performed entirely using keyhole (laparoscopic) techniques, with incisions of less than 1 centimetre. A camera and the surgical instruments required for the operation are inserted into the abdomen through these incisions. These instruments are specially designed to pass through the small openings. A small stomach tube is created at the upper part of the stomach and separated from the rest of the stomach. This small pouch becomes the functioning stomach after the operation. No organ is cut out and removed from the body. The new stomach pouch is then connected to the small intestine so that food can pass into the intestines. This constitutes the second part of the operation.
Who is a candidate for mini gastric bypass?
To be eligible for mini gastric bypass, you need a body mass index (BMI) of at least 35. The operation takes 30–60 minutes, and you may be discharged 24 hours after surgery.
How does mini gastric bypass lead to weight loss?
Mini gastric bypass promotes weight loss in three different ways: by reducing the stomach volume, restricting absorption and regulating hormones. With the first, reducing the stomach volume, your portion sizes will become smaller. With the second, restricting absorption, the first section of the small intestine, about 200 cm long, is separated from the flow of food. This separated section carries bile and other fluids that enable digestion and absorption. Thanks to this restriction of absorption, the amount of weight you lose is greater and the weight loss is maintained over the long term. The third way, hormonal regulation, results from the rest of the stomach remaining passive inside the body. Because food can no longer pass into this part, it is no longer stimulated and its activity decreases. As a result, secretion of ghrelin, the hunger hormone, is reduced.
How are the stomach and small intestine connected?
The stomach and small intestine are joined using special surgical staplers. These staplers are instruments designed specifically for keyhole surgery. By joining the stomach and intestine, an opening is created between them to allow food to pass through. This opening is called an anastomosis.
When can I be discharged after mini gastric bypass?
You can get up 4 hours after a mini gastric bypass and start eating and drinking by mouth 24 hours after the operation. If follow-up checks and examinations show no problems, you can be discharged 3 days after surgery with dietary guidance.
How should I eat after mini gastric bypass?
After mini gastric bypass, you will need to follow an eating plan prepared especially for you by your dietitian. In general, small amounts of water, apple juice or other fruit juices may be given on the day after surgery. For about the first month, you can have liquid or semi-liquid foods, skimmed milk and low-fat yoghurt, yoghurt-based soups, fruit purées made with yoghurt, puréed pulses and stews, cereal with skimmed milk and low-fat cheese. Apart from these, chocolate, honey, cake, desserts, syrups, ice cream, fizzy drinks, alcoholic drinks and any foods containing sugar should be avoided, as they may cause vomiting.