Gastric Bypass restricts both food intake and food absorption. A small part is separated at the stomach entrance and sutured to the small intestine. As the stomach shrinks, food intake is restricted.
What is Gastric Bypass Surgery?
Gastric Bypass means creating a passageway from the stomach to the intestines in general surgery. It is a method applied in various diseases that obstruct the stomach outlet. Gastric Bypass, in the sense used in obesity surgery, is a surgical method in which most of the stomach is disabled and the food taken is digested by using almost only half of the intestines.
Which Patients Is Gastric Bypass Surgery Applied?
It can be applied to patients with obesity who cannot lose weight, or who have complaints such as insulin resistance and joint discomfort due to excess weight. It was the most common surgical method until five years ago. However, as the gastric sleeve became more popular, the frequency of its application decreased. It is now applied as a second surgery (revision surgery) in patients who gain weight after sleeve gastrectomy. It can also be applied to all patients who have previously undergone tube stomach, gastric band, gastric folding, or vertical gastroplasty as revision surgery. Again, all of these procedures can be done laparoscopically (closed) method.
Do Diseases Such As Diabetes, Asthma, Blood Pressure obstacle Gastric Bypass Surgery?
On the contrary, these are the diseases caused and exacerbated by obesity. These diseases are not an obstacle for surgery but a reason.
Which Examinations Are Performed Before Gastric Bypass Surgery?
First of all, the following examinations and tests are applied to each patient before the surgery.
- Blood Biochemistry tests
- Hormone tests
- Hepatitis tests
- Whole abdominal ultrasound
- Stomach endoscopy (with anesthesiologist)
ECG (Heart Graph)
- Lung X-ray
- Lung respiratory test
- If required, effort test and ECO (Electrocardiography)
After all these tests, necessary examinations and examinations are performed by Anesthesiology, Internal Medicine, Cardiology, Chest diseases and Endocrine specialists. As a result of these examinations, it is first checked whether there is another underlying disease that may cause the patient to gain weight. If there is no such disease, the patient is examined in terms of anesthesia, like any patient who will undergo surgery, and it is checked whether there is an obstacle to the operation. Relevant specialists make recommendations about pre-operative treatments, if necessary. In this way, problems that may occur during and after surgery are minimized.
How is Gastric Bypass Surgery Performed?
The entire procedure is performed by laparoscopic (closed) surgery method. Laparoscopic surgery is performed by making 3 or 4 small incisions. The ports placed through these incisions are used for hand tools to reach the abdomen. One of them is a surgical telescope connected to a video camera and the others are for the introduction of specialized surgical instruments. The surgeon watches the operation on a video monitor. With experience, an experienced laparoscopic surgeon can perform many procedures laparoscopically, just as in open surgery.
Does it matter which brand the materials used during gastric bypass surgery are?
There are many different products on the market. The materials of the two leading American companies are the best quality products that are currently on the market and used all over the world. However, their costs are much higher than Chinese products used for the same purpose. Moreover, safety is important, not cost, in health. Each product used has its own barcode containing its own serial number. The barcode of each material used is put in the patient file. Always ask about the material used.
Is Leak Test Performed in Gastric Bypass Surgery?
A leak test is performed during gastric bypass surgery and on the 2nd day afterwards. The purpose of the leak test performed in surgery is to determine whether there is a problem or not and whether there is a leak in the suture line. If there is a leak, additional stitches are placed on the relevant part to prevent leakage. Again, before starting liquid foods after surgery, a leak test is performed and necessary measures are taken and intervened in time.
Is there stitch up in Gastric Bypass Surgery?
It is controversial to place additional stitches on special materials called staples in obesity surgeries. Some surgeons think that suturing reduces the possibility of bleeding and leakage and that every patient should be sutured. Some surgeons say that although suturing reduces the possibility of bleeding a little, it does not reduce the risk of leakage, on the contrary, it may cause more leakage and bleeding after vascular injury while suturing. As a clinical approach, we are between these two.
Although we do not put additional stitches in every patient, if the stapler line is not safe enough for us, we definitely put additional stitches. The fact that our results are much better than the world averages shows that our method is more successful. The most important point here is that the surgeon performing the surgery should have the ability and experience to intervene and correct all kinds of problems.
Why Is Blood Thinner Used In Gastric Bypass Surgery?
During each surgery, there is a possibility that there is a blood clot in the vein and blocking any vein. This can cause serious problems when it’s a vessel that feeds vital organs such as the heart, lungs, and brain. As the weight of the patients increases, the risk of embolism increases. For this purpose, these patients are given blood thinners regardless of the surgery. Although it increases the risk of bleeding slightly, the benefit is much higher. The use of blood thinners starts before the surgery and continues for another two weeks. The duration of use may be further prolonged in patients with high risk, such as patients with cardiovascular disease or previous embolism.
Is There Any Pain After Gastric Bypass Surgery?
Since gastric bypass surgery is performed laparoscopically (closed), that is, by entering through millimetric holes, post-intervention pain is less than open surgery. Nevertheless, the phrase “He was operated, of course he will have pain” is extremely wrong. No patient should experience pain in the twenty-first century. Pain relief is completely prevented by applying postoperative painkillers to each patient. The important point here is this. Everyone’s pain threshold is different. Again, drug tolerance and bioavailability from the drug are different. Therefore, treatment cannot be standard. Pain relief treatment should be arranged individually according to the needs of each patient.
Is There Any Scars After Gastric Bypass Surgery?
Since the incisions are very small, the aesthetic results are also extremely good. After a few months, these lines will also be almost invisible. Once the wounds have healed, you will be recommended a cream to leave less scarring. If you use it for three months, you will get much better aesthetic results.
When Will Nutrition Begin After Gastric Bypass Surgery?
On the 2nd day of the surgery, you will start taking liquid food after the leak test is done. After the first two weeks of liquid nutrition, you will be fed with soft (puree style) food for two weeks. During this whole process, you will be in constant communication with our dieticians.
How will the Gastric Bypass Surgery be Nutrition, Vitamin and Mineral Supplements?
Protein supplements are given to patients during the first 15 days. Especially in the first year, various vitamin and mineral supplements are given to patients. These are not standard for every patient, and after the examinations performed in routine controls, it is decided according to the patient’s condition, what and how much he needs.
How Long Is The Recovery Process After Gastric Bypass Surgery? Can I Get Back to Work Immediately?
The surgery is laparoscopically (because it is performed closed, you can stand up and walk one or two hours after the operation.) Even during the period you stay in the hospital, you will not be a nursing patient, you will be able to do your own self-care. Patients who work at a desk or work in jobs that do not require heavy effort can return to work within a week. Patients who require it are required to take a break from work for at least one month.After the operation, patients are given a resting report for a sufficient amount of time.
When can you take a bath after gastric bypass surgery?
You can take a bath when you leave the hospital. There is no problem if the seams are open and wet. After showering, dry it with a clean towel, apply baticon on them and wait for it to dry. Baticon does not stain your clothes permanently. There is no need to use baticon after the tenth day.
Can Medication Be Used After Gastric Bypass Surgery?
Do not use any medication other than the ones we recommend for the first month. When a medication is recommended by another physician, you should definitely consult us. You can use any kind of medication after the first month. Still, try not to use too much painkillers and drink plenty of fluids after taking medication.
Will There Be Weight Gain Again After Gastric Bypass Surgery?
The risk of regaining weight after Gastric Bypass is very low. In order to get the maximum benefit from this physiology, the patient should only eat at meals, take 2-3 meals a day, and avoid snacks between meals. This surgery also requires changing the eating habits acquired over a long period of time. In almost all cases where weight gain was observed again in the late stages of the surgery, there was no increase in meal capacity. The reason for regaining weight is especially high-calorie snacks between meals. There is no known operation to eliminate the side effects of this type of eating habit.
What are the Disadvantages of Gastric Bypass Surgery Compared to Gastric Sleeve Surgery?
It can cause longer-term vitamin and mineral deficiencies (especially deficiency in vitamin B12, iron, calcium, and folate).
Dietary recommendations require lifelong vitamin-mineral supplements and follow-up.
Intervention options that can be made for weight gain again are more limited.
When there is a problem, there is no chance of intervention in the bile ducts and pancreatic duct with endoscopy. Procedures such as ERCP and biopsy cannot be performed.
There is no chance to control the closed and left stomach tissue by endoscopy.
Since the fundus part of the stomach that secretes Gharlin (appetite hormone) is not removed, the decrease in appetite is less than the tube stomach.