What Is the Mini-Gastric Bypass Surgery? How Is It Performed?

In obesity treatment, various surgical operations can be performed according to the needs of the patient. Mini-gastric bypass surgery is one of the most preferred treatment methods in this sense.

In the surgery which is applied for controlled weight loss, on one hand, the volüme of the stomach is decreased, on the other hand, the absorption of nutrition is restricted in the small bowel and the patient healthily loses weight. In the mini-gastric bypass surgery which is distinguished by its successful results, the beginning part of the stomach is separated from the rest and connected with the bypassed bowel.

Thus, it is provided that the patient eats less by being full faster. Besides, since the absorption of high calory foods is limited in this surgery, these foods are ensured to be thrown out of the body without digestion. The mini-gastric bypass prevents the occurrence of diseases which are arisen from weight, by providing obese patients lose weight healthy and permanently.

In the patients who will have a mini-gastric bypass, a set of tests and examinations are applied before the surgery. These tests are as follows:

• Hemogram
• Hormone tests
• Hepatitis
• Stomach endoscopy
• Blood biochemistry test
• Abdominal ultrasonography
• EGK
• Lung respiration test
• Chest radiography
• Echocardiography

The patient can undergo an operation if no situation is observed that prevents patients to take anaesthesia after the patient passes the tests and examinations. Mini-gastric bypass surgery is applied as laparoscopic, which is closed. The stomach reduction procedure is applied by entering the body through 4-5 holes in 1 cm diameter opened in the abdomen.

One part of the stomach divided into two parts is connected to the duodenum. The other part continues to do its duty. This operation prevents the consumed foods to enter the duodenum. The surgery provides patients being full faster by eating less, and absorb a part of consumed foods.

The mini-gastric bypass surgery takes 1,5 hours on averagely. However, the patient may be subjected to long treatment stages before the surgery. After completing the necessary tests and examinations, if the patient has appropriate blood values and data, he/she taken to surgery. Since this surgery is performed a closed way, small cuts are made instead of the whole abdominal in patients.

Thus, no suturing necessity occurs and the surgery takes much shorter compared to the full abdominal cutting surgeries. After the surgery, the patients kept under observation for a while to understand whether there is any leakage in the patient. Afterwards, if no problem is observed in the patient that begins to nourished with liquid and puree the patient is discharged from the hospital.

Mini-gastric bypass is a kind of morbid obese surgery and can be applied in the treatment of the diseases that occur with obesity. However, this surgery is not applied to all obese patients. There are specific criteria for this, and one of the most important ones of these is the body mass index value. Body mass index is a value that is calculated according to the weight and the height of the patient. If this value is between 35-40 and the diseases such as type 2 diabetes, sleep apnea, hypertension are observed, the patient is suitable for the surgery. For the patients who have a body mass index above 40, having or not a disease with obesity is not important for the surgery.

This surgery can be applied as revision surgery for the patients who had a sleeve gastrectomy, stomach stapling, stomach folding or vertical banded gastroplasty surgeries and gained weight again. Having any metabolism disease and its severity are among the criteria for surgery.

The patients who had mini-gastric bypass surgery, generally stay in hospital for 3-4 days. While it is not possible to eat just after the surgery, from 2. or 3. days liquid, puree and then solid food is switched. The patients that no problem is observed, is discharged from the hospital. The patient who should not lift heavy loads may return to their normal life in 2-3 weeks, even they can begin to sport.

After mini-gastric bypass surgery, the patients should not return to their old dietary habits and should gain a sporting habit. The patients who nourish by adding balanced and healthy foods to their diet and consume small portions achieve healthy weight loss. To prevent dehydration after the surgery, it is necessary to consume adequate water. Drinking at least 1.2-2 litre water and consuming soft foods is important for patients in the beginning. It is necessary to avoid consuming refined sugar. Taking enough protein and calcium is quite important. Besides, not taking solid and soft foods at the same time is suggested for patients.

Generally, serious weight loss is observed in patients who had mini-gastric bypass surgery during the first 10-15 months process in pursuit of the surgery. The surgery that has quite a high success rate compared with the sleeve gastrectomy surgery, decreases the appetite of the patient and limits the food absorption. Therefore, it accelerates the treatment process in type 2 diabetes patients. Most patients lost 75% of their excess weight during the 1 year after the surgery. In the second year, this rate increases to 80% or 90 %. Mini-gastric bypass provides removing the obesity caused problems in addition to the obesity. There are problems such as self-confidence problem, can’t go out in public and can’t walk depending on over loan on waist and knees among them.

• Mini-gastric bypass is a kind of reversible surgery. This means different from the surgeries like sleeve gastrectomy surgery, there are no irreversible form changes in the stomach of the patient.
• In addition to unappetising in the patient, it decreases the absorption, thus it provides healthy and controlled weight loss.
• It is a therapeutical method against diseases like type 2 diabetes and so on.
• The complication rate of it is quite low.
• The rate of gaining the weight that lost is low for the patient.
• Alongside the patients gain their health back, it provides feeling better psychologically and being self-confident. So, it reintegrates the individuals into society.

Every surgical intervention brings some of the risks with it even it is small. In mini-gastric bypass surgery, risk factors depending on patient takes anaesthesia may occur. One of the biggest risks of the surgery is leakages or bleedings.

These factors are removed by keeping under control patient and subjecting them to tests. Although mini gastric bypass is a beneficial operation for healthy and controlled weight loss, it brings along some disadvantages.

• The patient may be kept in the hospital for control for a long time.
• The patient needs to take test regularly and followed closely in the further stages.
• Since it is a more complicated and longer surgery compared with the other gastric surgeries, the complication risk is higher.
• In some conditions, malabsorption may be seen in the patient and this situation may require lifelong vitamin and mineral supplement. If the patient keeps not taking the food supplements, he/she can face problems arising from vitamin deficiency.
•  In further stages, problems like intestinal obstruction or ulcer may occur.
• A “Dumping Syndrome” which occurs due to the foods pass very quickly from the stomach to the bowels, may occur. This syndrome Show up with symptoms such as diarrhea, stomachache or cramp 30 min. After eating foods in the patient. Thus, the patient needs to regulate his/her dietary habits and decrease the portions. Also, avoiding sugary foods prevents the occurrence of the syndrome.

Diabetes surgery carries a risk the same as ordinary digestive system surgery. With the opportunities of changed and developed Turkey technology, the risks of the operation decreased day by day. This surgery is one of the ultimate surgeries.
First of all, detailed tests from various branches should be done before the operation because the possibility of the patient may have a disease that is not diagnosed or the patient is not know should be taken into account.
During the surgery, the values of the patient are followed in detail and the negativities kept under control by the doctor.

• The narcosis which is applied in the other surgeries is used in type 2 diabetes surgery. There are negative effects of this narcosis.
• Bleeding may occur.
• Congelation which is defined as the pulmonary embolism may occur. As a result of stop and/or slow down the bloodstream a congelation may occur beginning from the legs to lung vessels.
• Minor damages like pulmonary infection and abscess formation from the legs may occur.
• The most unease one among the risks is the anastomosis leak complication.
• In case of not paying attention or noticing late, it can cause serious health problems. The infection steps in here and ruins the situation of the patient.