What is Gastric Bypass Surgery?
Gastric bypass surgery is one of the most effective methods in obesity surgery. In this method, the procedure is performed on both the stomach and the small intestine. First, the stomach volume is reduced, which consequently decreases the amount of food the patient can consume. Second, nutrient absorption is decreased as the path through the small intestine is shortened.
What Types of Gastric Bypass Are There?
- Roux-en-Y Gastric Bypass
- Mini (Single Anastomosis) Gastric Bypass
Roux-en-Y Gastric Bypass
During the surgery, the upper part of the stomach is divided into two using a special stapling device, leaving approximately 25-30 cc of stomach volume. This results in a small stomach pouch and the remaining part of the stomach. A connection is made between the small stomach pouch and the small intestine. This new connection between the pouch and the small intestine is called the Roux-en-Y limb. As a result, food from the esophagus directly passes from the small upper part of the stomach into the small intestine, bypassing the majority of the stomach and the duodenum.
Mini (Single Anastomosis) Gastric Bypass
In this procedure, the stomach is vertically reduced into a tube shape using special staplers. The newly formed stomach pouch is larger than the Roux-en-Y type. The small intestine segment is then connected to this newly formed stomach pouch at approximately a 200 cm distance. The key difference from the Roux-en-Y type is that it is technically easier and involves only one connection. The weight loss mechanism is the same for both types of gastric bypass.
What Are the Risks of Gastric Bypass?
This procedure carries risks common to many abdominal surgeries, such as bleeding, infection, post-surgery ileus (intestinal obstruction), hernia, and general anesthesia complications. The most serious risk is leakage (leak) at the connection site between the stomach and small intestine, which may require a second surgery. Generally, more serious complications are rare, and common complications are treatable and manageable.
Am I a Candidate for This Surgical Procedure?
If your BMI > 35 kg/m2 or if your BMI is between 30-35 kg/m2 with obesity-related medical issues (such as type 2 diabetes, hypertension, sleep apnea, etc.), you may be a candidate for this surgery. Patients who undergo gastric bypass surgery typically have previously attempted conventional weight loss methods but were unsuccessful. Even if you meet these general criteria, an assessment of your medical, nutritional, and behavioral suitability for the surgery is necessary.
What Should I Do in the Second Step If I Am Eligible?
Your doctor will review your records and meet with you to discuss the details of the surgery. During this meeting, you will also be informed about the nutritional guidelines to follow post-surgery. You will be monitored by your doctor for both medical and nutritional follow-ups after the surgery.
How Long Will I Stay in the Hospital?
You are expected to stay in the hospital for 2-4 days, but the duration may be extended if issues arise during pre-surgery evaluation or post-surgery recovery.
How Long Will It Take to Recover?
After leaving the hospital, it is important to restrict heavy activities (no lifting heavy weights for 6 weeks, no driving for 2 weeks). You may walk, climb stairs, and take showers. Patients with less physically demanding jobs can return to work after 2-3 weeks. If you have a job that requires intense physical activity, you may need to wait 6-8 weeks. Keep in mind that this is a major surgery, and you may sometimes feel weak or fatigued.
Is Gastric Bypass Reversible?
Gastric bypass surgery can be reversed, but it is a serious procedure with some risks. The best approach to avoid a second surgery is to adopt proper new eating habits.
Do I Need to Take Vitamins/Minerals After Surgery?
Yes. Post-gastric bypass vitamin and mineral supplementation is recommended according to the ASMBS (American Society for Metabolic and Bariatric Surgery) Nutrition Guidelines. Your doctor and nutritionist will determine the appropriate vitamin/mineral supplements based on your individual condition after surgery.
How Much Weight Will I Lose?
Weight loss occurs gradually, with the fastest loss occurring in the first few months. Maximum weight loss may take 1.5-2 years. 70-80% of your excess weight will be lost within this time. In some patients, this rate may rise to 85-90%.
