Gastric bypass surgery, which is the leading of the oldest cornerstone surgeries in bariatric surgery, is the most frequently performed bariatric surgery method, especially in the United States. Although this rate has changed in favor of sleeve gastrectomy in the recent period, it retains its status as a frequently performed surgery.
The main purpose of bariatric surgery is to reduce morbidity and mortality related to obesity, and to improve metabolic and organ functions. Selecting the appropriate patient and technique is very important 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 bariatric surgery.
Roughly, 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 is between 32 and 40. On the other hand, if the BMI is over 40, sleeve gastrectomy can be planned without requiring the presence of chronic diseases related to obesity, as it is considered morbid obesity.
Gastric bypass surgery shows its effect through three mechanisms:
1. Through the restrictive effect, as the stomach volume is reduced,
2. By reducing absorption, as the small intestine is bypassed,
3. Through the hormonal effect.
Gastric bypass surgery results in the loss 70-80% of excess weight through these three mechanisms. This effect is more permanent and stronger than that of sleeve gastrectomy. Gastric bypass surgery is performed using 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 weight regain is lower than with sleeve gastrectomy. Therefore, the need for revision surgery is less common.
• In the presence of type 2 diabetes, blood sugar control and regulation are more effective and permanent than with sleeve gastrectomy.
• In the presence of reflux or stomach hernia, the first option is bariatric surgery due to its curative effect on reflux.
Its Disadvantages
• The duration of the surgery is longer, and it is a technically more difficult surgery.
• The replacement of vitamins and minerals is needed permanently.
• The risk of developing osteoporosis is higher in the long term.
• Depending on nutritional habit, it can cause dumping syndrome.
• It causes difficulties in diagnosis and follow-up due to the difficulty of accessing this area in possible pathologies, since the deactivated stomach is not removed.
• Revision surgery is very difficult in the case of possible weight gain.
In summary, gastric bypass surgery is one of the most fundamental surgeries in bariatric surgery, with both short- and long-term results that are well known. When applied to the appropriate patient, the results are quite favorable.
After gastric bypass surgery, the nutritional plan is especially important, particularly in the first month. The transition from liquid foods to soup, puree, and finally solid foods is done gradually. This period is generally more easily tolerated by patients compared to sleeve gastrectomy. All this information is explained in detail by our dietitian and our team. Protein and vitamin supplementation is required for the first three months after gastric bypass surgery. Also, long-term vitamin B12 supplementation is necessary.
General Recommendations After Gastric Bypass
- Drink 6 to 8 glasses of fluid a day.
- Stop consuming liquids 30 minutes before meals and resume 30 minutes after meals.
- Sip your drinks slowly.
- Do not use a straw, as it can cause you to swallow air along with the drinks.
- Strive for a healthy and balanced diet, avoid foods and drinks with high energy content in your diet.
- Eat little by little and frequent meals 4-6 times a day.
- Take 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 become pregnant for 1.5 years after the surgery.
