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-Gastric bypass surgery
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What is Gastric Bypass Surgery?
Gastric bypass surgery is a common method in obesity surgery. It is a combined method that decreases the level of absorption and causes malabsorption.
Gastric Bypass surgery is performed by shrinking the stomach into a small pouch and by taking the small intestine from a certain segment to the shrunk stomach and making an upward connection. Unlike in gastric sleeve surgery, the rest of the stomach is not removed. However, there is no entrance to the remaining stomach for food consumption. Stomach acids and enzymes continue to be produced for digestion and absorption of nutrients from the rest of the stomach.
Thus, patients who have had Gastric Bypass both have less food consumption and thus take fewer calories due to the reduction of the stomach into a small pouch. Besides, a decrease in the absorption of high-calorie foods taken due to the transition from the remaining small stomach to the small intestine is created, and thus also provides weight loss. Therefore, weight loss is provided in an issue of obesity with two different mechanisms.
After gastric bypass operations were performed with the laparoscopic method. Thus there is no deep incision in the skin and pain associated with the operation. General anesthesia is used for the operation and takes approximately 1 hour. Although extensive pre-op tests are performed before the surgery, consultations are made with chest diseases, anesthesia, psychiatry, and endocrinology units. After the surgery patient’s leakage test. Patients are discharged on the second day after the operation.
What does Malabsorbtion mean in Gastric Bypass Surgery?
Gastric Bypass surgery involves the deactivation of a longer part of the upper digestive system, the “malabsorptive” effect of the operation, which is disrupting the absorption of food, is very critical. As the bypassed small intestine segment contains a long and almost 2 – 2.5 meter section of the small intestine, the exposure of the foods taken with pancreas and bile secretions is also reduced, and this will further reduce the absorption of fats. Therefore, it is a necessity to maintain both protein support and vitamin and mineral support for a lifetime under the supervision of a dietician after this surgery.
How Long Does Gastric Bypass Surgery Take?
The duration of gastritis bypass surgery is approximately one and a half hours. Before this surgery, the patient can be treated for a long time. After the necessary tests and examinations are completed, the patient is operated on. Small incisions are made during the operation. While some doctors may need stitches, some of them may not. After the operation, the patient can be kept in the hospital to see if there is a leak, as in sleeve gastrectomy. Afterward, the patient is fed with liquid or pureed food for a while.
What are the types of Gastric Bypass Surgery?
The types of gastric bypass surgery are divided into two segments as gastric bypass surgery and mini gastric bypass surgery. The main purpose of gastric bypass surgery is to decrease the volume of the stomach to ensure that the food consumed reaches the intestines faster. There are two goals achieved. The first one is to reduce the size of the stomach to make the patient feel full easily. The second one represents the event that the nutrients are getting fewer calories from nutrition intake as they pass faster through the stomach, which limits weight gain.
In mini gastric bypass surgeries, the patient can recover in a shorter time. In this operation, a shorter route directly to the stomach – small intestine is provided to restrict the amount of the current caloric values of the foods taken. After the mini gastric bypass operation, the patient can be discharged by staying in the hospital for at least two to four days.
What needs to be considered before the procedure?
An eating habit should be had to lose some weight before the medical procedure. This method both diminishes the dangers related to a medical procedure and can facilitate the surgery with the least chance of complications. All standardized tests are led to a medical procedure arrangement for gastric bypass surgery. Respiratory capacities are assessed. Likewise, before the surgery, the status of the stomach is assessed with endoscopy for conceivable gastric pathologies. Along these lines, potential inconveniences are forestalled. Discussions will be done from cardiology, endocrinology, chest, psychiatry, and anesthesiologist units to plan the surgery with received information about the patient’s medical history with a series of tests. The patient is informed to fast the night before the surgery. The patient is informed about vascular clots and blood thinners.
What needs to be considered after the procedure?
After surgery, patients can feel satiated much earlier than before while having a small portion of food.
As a result of having gastric bypass surgery the total amount of food intake is significantly reduced. Due to the smaller size of the newly formed stomach and reduced food absorption, the instructions of the surgeon should be followed.
One of the main items to pay attention to is nutrition intake after the gastric bypass surgery. Below, there is a list of points to be careful about. These are:
- Consuming enough vitamins – minerals to prevent deficiency. These can lead to hair and/or hair loss.
- Consuming a small number of solid foods as much as possible.
- Focusing on a diet plan with high protein ingredients with low carbohydrate ingredients.
- Removing all kinds of carbonated drinks, processed fat, and sugar for life.
- Minimizing the consumption of caffeine and salt to its minimum.
- Having 3 main meals and 3 snacks in 1 day.
- Having a diet plan that focuses only on fruits for snacks.
- Having a habit of chewing food thoroughly.
- Consuming a minimum of 2.5 liters of water daily. These rates do not apply immediately after the surgery. It can progress gradually as 1 liter in the first week, 1.5 liters in the next week, and 2.5 liters in the following periods.
What are the risks involved with Gastric Bypass Surgery?
In any other surgical procedure, gastric bypass surgery has potential involved risks and complications. These are rare and all is done to prevent them from happening. The most common complications are leakage, bleeding, and embolism. These risks can be seen especially in the first 15 days after surgery. When symptoms of complications are seen, contact your doctor immediately. This will help shorten the treatment process of complications and can affect the success of the treatment positively.
The riskiest complication of this surgery is to have leaks in the staple line. Symptoms of leakage can be the following: high fever, severe abdominal pain, high pulse, tremors, and feeling weak. In the treatment of possible leaks timely and successful interventions of your doctor play a crucial. Detection and treatment of leakage are very easy for an experienced obesity surgeon. Only the process is getting longer.
Another risk involved with gastric bypass surgery is the risk of embolism. There is always a risk of embolism in every surgery; However, in bariatric surgeries, the risk of embolism is higher because of patients’ obesity issues. To prevent the risk of embolism, a blood thinner injection is started one day before or on the day of surgery, and patients are dressed in embolism stockings. The patient should use the anti-embolism stocking and blood thinner needle for ten days at home after discharge.
The most common type of complication is bleeding. Observation of bleeding is easy with drain. The patient who has bleeding can experience low blood pressure, dizziness, and weakness. Treatment of bleeding can be quick with the only supplementation of blood, depending on the amount of bleeding.
Apart from these, vitamin-mineral deficiencies may occur due to malnutrition and decreased absorption. Patients should have regular blood assays after surgery and regularly use the medications and supplements for vitamin and mineral deficiencies.
‘Dumping syndrome’, also called rapid gastric emptying, is seen when food, especially sugar, passes from the stomach to the small intestine very quickly. Dumping syndrome occurs 10 to 30 minutes after eating and causes symptoms such as abdominal pain, cramping, and diarrhea in individuals. It helps prevent post-operative nutritional changes syndrome. Dumping syndrome can be prevented by eating smaller meals and limiting high sugar foods.
In conclusion, gastric bypass surgery is an extremely harmless operation. If you are severely obese and have trouble losing weight, your healthcare provider may recommend gastric bypass surgery.