The gastric bypass surgery, which is the leading of the oldest cornerstone surgeries in the bariatric surgery, is the most frequently bariatric surgery method, especially performed in the United States. Although this rate has changed in favor of the sleeve gastrectomy in the recent period, it protects its feature of frequently performed surgery.

The main purpose of the bariatric surgery is to reduce morbidity and mortality depending on the obesity, and to improve metabolic and organ functions. The appropriate patient and appropriate technique selection is very important in order to provide the highest benefit with the lowest risk. Therefore, the individuals, who are suitable for the surgery, are required to have certain criteria. Regardless of the BMI value, all individuals are required to have tried to lose weight with diet and exercise for 6 months before the bariatric surgery.

Roughly; the sleeve gastrectomy can be planned in the presence of at least two co-morbidity diseases (hypertension, diabetes, sleep apnea, etc.) in the patients whose BMI value is between 32 and 40. On the other hand, if the BMI value is over 40, the sleeve gastrectomy can be planned without the condition of the chronic disease depending on the obesity, since it is mentioned from the morbid obesity.

The gastric bypass surgery shows its effect with three mechanisms:

1. With the restrictive effect since the stomach volume is reduced,

2. By reducing absorption, since the small intestine is bypassed, 

3. With the way of the hormonal effect.

The gastric bypass surgery provides the end of the obesity by causing 70-80% of excess weight to be lost in these three ways. This effect is more permanent and stronger than the sleeve gastrectomy. The gastric bypass surgery is performed with the laparoscopic (closed) method. The surgery takes approximately 45 minutes in our series. The average hospital stay duration is 3 days.

Its advantages

• The rate of gaining weight again is lower than the sleeve gastrectomy. Therefore, the need of the revision surgery is seen less.

• In the presence of the type 2 diabetes, the blood sugar control and regulation are more effective and permanent than the sleeve gastrectomy.

• In the presence of the reflux or stomach hernia, the first option is the bariatric surgery because of its curative effect on the reflux.

Its disadvantages

• The surgery duration is a longer and it is more difficult surgery technically.

• The replacement of the vitamin and mineral is needed permanently.

• The risk of developing osteoporosis is higher in the long term.

• Depending on the nutritional habit, it can cause dumping syndrome.

• It causes difficulties in the diagnosis and follow-up due to the difficulty of reaching this area in the possible pathologies, since the deactivated stomach is not removed.

• The revision surgery is very difficult in case of the possible weight gain.

In summary, the gastric bypass surgery is one of the most basic surgeries of the bariatric surgery, of which short and long-term results are well known. When it is applied to the appropriate patient, the results are quite humorous.

After the gastric bypass surgery, the nutritional order provides speciality especially in the first month. The transition from the liquid foods to soup, puree and finally solid food is applied in a gradual manner. This period is generally more easily tolerated by the patients than the sleeve gastrectomy. All this information is explained in detail by our dietitian and our team. The protein and vitamin supplementation is required for the first three months after the gastric bypass surgery. There is need of the long-term vitamin B12 supplementation.

GENERAL RECOMMENDATIONS AFTER THE GASTRIC BYPASS

• Drink 6 to 8 glasses of fluid a day.
• Stop liquid consumption 30 minutes before meals and start consuming 30 minutes after meals.
• Sup off your drinks and slowly.
• Do not use a straw. You can also swallow air with the drinks consumed with the straw.
• Strive for a healthy and balanced diet, do not include foods and drinks of which energy content is high in your diet. 
• Eat little by little and frequent meals 4-6 times a day.  
• Use your vitamins and minerals in a way recommended by your doctor 1 month after the surgery. After the surgery, you should take vitamin B12 supplements for life.
• Use protein supplements for the first 3 months after the surgery. If you prefer whey instead of the bariatric protein as protein, you should start vitamin and mineral supplements right away.
• Eat your meals slowly and chew very well. Make sure that the time spent for each meal is at least 30 minutes.
• Stop eating when you feel saturation during a meal. The signs of oversaturation are bloating, nausea, and a burning/painful feeling from your stomach to your chest.
• Consume the foods containing protein first. 
• The nutritional stages in your diet can vary depending on the person, therefore, act according to your tolerance status.
• In order to prevent the risk of embolism (blood accumulation in the vein and causing coagulation in the vein), wear the anti-embolic stockings given to you by our nurses after the surgery in a way that they remain above the knee for 10 days.
• Do your triflow (breathing) exercises for at least 5 minutes the top of the hour after the surgery. This will help your lung capacity return to normal. Continue your exercises after the discharge.
• The pain experienced after the surgery is usually gas pain. It is important to start walking slowly as of the 4th hour after the surgery to eliminate this complaint. 
• Smoking is not recommended after the surgery.
• It is not recommended to get pregnant for 1.5 years after the surgery.