There are many methods used in obesity surgery. Gastric Bypass surgery is one of the most preferred surgical methods in obesity surgery.
What is Gastric Bypass (RYGB) surgery?
Laparoscopic Gastric By-Pass (R-YGB) surgery is the most common type of combined surgery. Gastric Bypass is one of the methods that draws attention with its successful results in obesity surgery. With this operation, while the stomach volume is reduced, the absorption of nutrients decreases because the path traveled in the small intestine is shortened.
The part at the beginning of the stomach is separated from the rest, removing about 30-50 cc. A part of the small intestine is also bypassed and connected to the newly formed small stomach. In this way, patients reach the feeling of fullness quickly with much smaller portions. In this way, patients reach the feeling of fullness quickly with much smaller portions. At the same time, the absorption of a significant part of the high-calorie foods taken is prevented.
Effective and permanent weight loss is achieved with Laparoscopic Gastric Bypass (RYGB) surgery. Similar to volume-restricting operations, patients achieve a feeling of fullness quickly with much smaller portions due to the reduced new stomach pouches.
Gastric By-Pass surgery can be recycled when it is necessary.
In Which Diseases Are Gastric Bypass (RYGB) Operation Used?
Gastric Bypass (RYGB) is primarily a morbid obesity operation. Gastric By-Pass (R-YGB) treatment can be applied in the presence of many diseases accompanying obesity. Chief among these is Type 2 diabetes. Positive results can be obtained with gastric bypass surgery in the surgical treatment of Type 2 diabetes patients who cannot be controlled.
How Is Gastric Bypass (RYGB) Operation Performed?
Before Gastric By-Pass Operation
Patients who are planning to have an operation undergo a detailed evaluation. In addition to physical examinations, each patient is evaluated in detail before operation by endocrinology and psychiatry specialists.
How is the operation done?
- Gastric By-Pass is performed by laparoscopic method. In recent years, robotic surgery can also be preferred.
- Operation is performed through 4-6 holes with a diameter of 1 cm.
- In gastric bypass operation, the stomach is shrunk, just like in sleeve gastrectomy surgery. Approximately 95% of the stomach is bypassed.
- A part of the stomach, which is divided into two by surgical methods, is attached to the middle of the intestine by bypassing the 12 finger intestines. In the other part, it continues its task by not being removed from the body. Thus, the food consumed is prevented from passing through the 12-finger intestines.
- With the operation, it is aimed to saturate the patients with less food and to ensure their absorption of some of the food they take.
After the operation
Patients are checked in the hospital for 4-6 days. At the discharge, the diet until the first control is planned by the dietitian. During the first year, close follow-up is performed by an endocrinologist, psychiatrist, and dietitian apart from the obesity surgeon.
What are the Gastric Bypass Types?
Roux en Y Gastric Bypass: In the surgery, from the point where the stomach meets the esophagus, a volume of approximately 25-30 cc remains, and the space between the two stomachs is divided into two with a special stapler. Thus, a small stomach pouch and the other part of the stomach are left behind. At the same time, a connection is established between the small intestine and the small stomach pouch by forming a stoma. The new connection between this pouch and the small intestine is called the Roux en Y arm.Thus, food passing the esophagus bypasses most of the stomach and the first part of the small intestine.
Mini-Gastric Bypass: In this type, the stomach is formed as a tube by using special stapler tools. This newly created stomach pouch is larger than the Roux en Y type. Then, the small intestine segment connects with this newly formed gastric pouch from a distance of about 200 cm. The most important difference from the Roux en Y type is that it is technically easier and only one connection has been found. The mechanism of weight loss is the same in both gastric bypass types.
What are the Risks of Gastric Bypass Operation?
- In this procedure, bleeding, infection, postoperative ileus (intestinal obstruction), hernia, and general anesthesia complications can be seen, which can also be seen in many other abdominal operations.
- The most serious risk is the leakage that may occur in the connection between the stomach and the small intestine and a second operation that may occur as a result.
- Some additional surgical risks increase depending on obesity. Blood clot formation (embolism) and cardiac problems may occur in the feet and lungs.
- 10-15% of patients who undergo this operation experience some of the above complications. In general, more serious complications are rare and the common ones are acceptable and treatable.
For Which Patients Is Gastric By-Pass Operation Suitable?
Obesity surgeries are evaluated according to body mass index. Patients with a body mass index of 40 and above or patients with a body mass index of 35-40 and who have medical problems such as obesity-related type 2 diabetes, hypertension, and sleep apnea are appropriate for this operation.
How Long Will You Stay in the Hospital After Gastric By-Pass Operation?
Patients usually stay in the hospital for 3-4 days. Problems that may occur during the preoperative evaluation and postoperative recovery period may prolong this period.
Can Patients Lift Heavy After Gastric By-Pass Operation?
After leaving the hospital, heavy activities should be restricted. The patient should not lift heavy loads for 6 weeks.
When Can A Car Be Used After Gastric By-Pass Operation?
After the operation, the patient should not drive for 2 weeks but can walk, climb stairs and take a shower.
When to return to work after Gastric By-Pass Operation?
Patients with a quiet work-life can return to work after 2-3 weeks, but patients with intense physical activity should wait 6-8 weeks after the operation.
When Does Weight Loss Start in Gastric By-Pass Operation?
Weight loss occurs gradually, the fastest in the first months. It may take 1.5-2 years for maximum weight loss and 70-80% of the excess weight is lost during this period.
What should be considered in nutrition after a gastric bypass operation?
- At least 3 meals a day should be eaten and well-fed.
- Meals should include primarily protein, fruit, vegetables, and lastly whole wheat grains.
- Liquid foods should be consumed especially in the first 2 weeks, and puree foods should be consumed between the 3rd and 5th weeks.
- At least 1.5-2 liters of fluid should be consumed to prevent dehydration. (With a minimum of 6-8 glasses of water a day) Otherwise, headache, dizziness, nausea, weakness, white sores on the tongue and dark urine, etc. situations may occur.
- Soft and clear foods should be consumed. For example, diet/diabetic puddings prepared with low-fat milk, mashed potatoes, milk-soaked cereals, cottage cheese, soft omelets, and mashed fish can be preferred.
- Simple sugars (granulated / sugar cubes, confectionery, sweets, etc.) should be avoided.
- It is important to chew the food a lot and to swallow it when the food is pureed. If food is not chewed sufficiently, it can block the stomach outlet, causing pain, discomfort, and vomiting.
- It should be ensured that a sufficient amount of protein is taken. 3 cups of skim milk or soy milk a day can provide enough protein and calcium to stay healthy.
- Solid meals and liquid foods should never be taken at the same time. Drinking liquid with meals fills the remaining small stomach and causes early vomiting. It may cause a feeling of early satiety by stretching the stomach, or it may not reach the feeling of satiety by washing the stomach early and cause you to eat more.
- No liquid should be taken for 30 minutes before or after meals.
- Food should be eaten slowly. 2 plates of food should be eaten in 20 minutes. Many keep the average time at 45 minutes
- Eating and drinking should be stopped when a feeling of fullness or pressure is felt in the middle of the abdomen.
- It will be beneficial to keep a diary of the consumed foods and write down your results.
If there is a complaint of vomiting regularly, professional support should be sought.
Is Constipation Experienced After Gastric By-Pass Operation?
Because the food is eaten in smaller proportions than the foods consumed before the surgery, changes in bowel habits may occur. In the beginning, the need for the toilet may be once every 2-3 days.
- High fiber foods: Whole wheat breakfast cereals; foods made from hulled wheat products
- Baked beans
- Crackers made from whole wheat
- Constipation problem can be prevented if fruits and vegetables are consumed.
- In addition, it should be ensured that at least 8-10 cups of fluid are taken between meals.
What Is Dumping Syndrome After Gastric By-Pass Operations?
Excessive consumption of simple carbohydrate foods after operation may cause dumping syndrome. These are the complaints that occur when the stomach is emptied very quickly. In addition to preventing dumping syndrome by limiting the foods that may cause this in the nutrition program, an adequate and balanced diet plan can be made in the weight loss program.
I have decided to have Gastric Bypass (RYGB) operation. What should I do?
Please contact us from the price section on our site or through our communication channels. Our expert operation team organizes the doctor, hospital, accommodation, and transfer procedures for you from the beginning to the end of the operation.