What is Gastric Bypass?

Roux-en-Y Gastric Bypass (RYGB) is one of the most frequently applied methods in obesity and metabolic (diabetic) surgery in the world today. Although sleeve gastrectomy has been applied more frequently in recent years, especially in bariatric surgery, it still remains the most preferred method in patients who need metabolic surgery. It has been used safely for more than 30 years. As with other surgical options, it is applied laparoscopically, that is, by making small incisions in the abdomen or robotically.

Gastric bypass surgery is both restrictive and malabsorptive. In this method, a small stomach pouch of approximately 30-50 cc is created in the upper part of the stomach. The small intestine is cut and one end is attached to this pouch. The other end is connected approximately 150 cm ahead of this connection. Food goes to the small intestine through this pouch without passing the stomach. In this way, both volume is restricted and absorption is reduced.

What we aim with surgery; It is to deliver the food to the lower parts of the intestine without being absorbed, to stimulate this place and to increase the release of hormones that increase insulin sensitivity. We provide this with the displacement and change of direction between the upper and lower parts of the intestines, which we call bypass. In this way, effective and permanent weight loss is achieved. Similar to volume-restricting surgeries, patients can reach a feeling of fullness quickly with much smaller portions due to the reduced new stomach pouches.

What are the Advantages of Gastric Bypass?

 -  Greater weight loss rate compared to Laparoscopic gastric band (stomach clamp) or Sleeve gastrectomies (tube stomach)

 -  More effective weight loss, faster feeling of fullness

 -  Not using any foreign body (gastric band etc.)

 -  Being recyclable

 -  It can be preferred more in those with eating disorders

 -  Dramatic improvement in accompanying meatbolic diseases (over 90% improvement in hyperlipidemia, nearly 70% improvement in hypertension, 75% improvement in sleep apnea syndrome, improvement in asthma, 70-80% improvement in diabetes etc.)

 -  It is not refluxic like sleeve gastrectomy, and the recovery rate in gastroesophageal reflux disease (GERD) is around 90%.

What Are the Disadvantages of Gastric Bypass?

 -  It is technically more difficult than sleeve gastrectomy and gastric band operations, so the surgery takes longer

 -  Remaining part of the stomach that cannot be reached endoscopically

 -  Decreased absorption of some nutrients and vitamins due to bypass, therefore patients need lifelong vitamin and mineral supplements.

 -  They should continue on a low sugar and low carbohydrate diet. More frequent occurrence of nausea, bloating and diarrhea etc. (Dumping syndrome).

 -  Risk of internal herniation

 -  Anastomotic ulcer

What Are the Risks of Gastric Bypass?

 -  In this operation, bleeding, infection, postoperative ileus (intestinal obstruction), hernia (hernia), and general anesthesia complications can be seen, which can also be seen in many other abdominal surgeries.

 -  One of the most important and serious risks that can be seen is the leakage that may occur in the connection called anastomosis formed between the gastric pouch and the small intestine.

 -  The formation of potential cavities due to displacement in the intestines and the risk of herniation by passing through the intestines. It is one of the potentially fatal risks that may require emergency surgery.

 -  Risk of transporting the clot that may be in the legs to the heart and throwing it into the lungs (Pulmonary embolism)

 -  Risk of serious vitamin and mineral deficiencies

 -  Stomach ulcer, gallstones, incisional hernia, intestinal obstruction.