Gastric By-Pass

Length of Stay in Hospital
3 Days
Length of Stay in the City
7-10 Days
Recovery Duration
2 Weeks
Operation Duration
1-2 Hours
Type of Anesthesia
General Anesthesia

It is an operation applied to reduce the absorption of carbohydrate and fatty foods from the intestines. A large part of the stomach is bypassed and a small volume (approximately 30-50 cc) stomach section is formed and sutured to the small intestines in gastric bypass surgeries. As in other bariatric surgery operations, it is aimed to reduce the stomach volume and to disable a part of the intestines and to throw away some of the consumed food before absorption. Thus, patients are both satiated with less food and not all of the food they take is absorbed.

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How is Bariatric Surgeries Performed with Laparoscopic Method?

The entire procedure is performed by laparoscopic (close) surgery method. Laparoscopic surgery is performed by making many small incisions. Ports placed through these incisions are used for hand tools to reach the abdomen. One is a surgical telescope connected to a video camera and the others are for the entry of specialized surgical instruments. The surgeon watches the operation on a video monitor. An experienced laparoscopic surgeon can perform many procedures laparoscopically, just as in an open surgery.

How Is Gastric Bypass Surgery Performed and How Does It Work?

Gastric bypass limits both food intake and food absorption. Almost 95% of the stomach, duodenum and the first 1meter of the upper part of small intestine are medically bypassed. Gastric bypass reduces stomach size by over 90%. The stomach may enlarge up to 1000 ml, sometimes. Gastric bypass pouch is 15-30 ml in size. The gastric bypass pouch is formed in the upper part of the stomach that can be stretched the least. Therefore, there won’t be any significant increase in volume of the pouch in the long run.

When a small amount of food is ingested, the first response is the stretching of stomach’s wall and nerves stimulate the brain that the stomach is full. Patients feel full after a small portion of food has been consumed as if they have been eaten a large meal. Many people do not stop eating when they feel full. However, patients learn very quickly that they must eat their next bite very slowly and carefully to avoid increased discomfort or vomiting. Patients eat less and consumed food goes directly to the end of intestine from the stomach, so they lose weight quickly in this way.

One of the biggest advantages of this operation is that the taken food and the fluids (enzymes, gall and pancreatic fluids) produced by remaining gastric (non-food) converge at a later point, rather than immediately. Thus, the absorption of fat and sugar, that is the absorption of calories, are reduced (absorption reducing effect).

In addition, patients feel full longer with slow emptying time of the stomach since the transition point of the reduced stomach to the intestine is smaller than before.

Gastric Bypass Advantages

  • Reversion is possible since any part of the stomach is not destroyed.

  • Eating and drinking comfort and portion size are better than the sleeve gastrectomy operation.

  • It also treats reflux in patients with reflux or gastric hernia.

  • It creates a more permanent solution to Type 2 Diabetes and other related diseases.

  • It is less likely to gain weight compared to sleeve gastrectomy operation.

  • There is no liquid feeding period after the operation.

Disadvantages of Gastric Bypass

  • It is technically a more difficult operation for the surgeon.

  • Gastric ulcer is more common, especially in patients who smoke.

  • It is more likely to have dumping syndrome.

What are the Disadvantages of Gastric Bypass Compared to Gastric Sleeve?

  • Longer-term vitamin and mineral deficiencies (especially vitamin B12, iron, calcium and phosphate deficiencies) may result.

  • Dietary recommendations, lifelong vitamin-mineral supplementation and post operation follow-up are required.

  • Options are limited if patients regain weight.

  • Endoscopic intervention is not an option for bile-pancreatic duct when there is a problem. ERCP and biopsy cannot be performed.

  • There is no chance to control closed stomach tissue with endoscopy.

  • Since the fundus part of stomach that secretes Gharlin (appetite hormone) is not removed, appetite reduction is less compared to gastric sleeve.

Which Tests Are Performed Before Gastric Bypass Surgery?

The following tests and examinations are applied to every patient before the surgery;

  • Blood biochemistry tests,

  • Hemogram,

  • Hormone tests,

  • Hepatitis tests,

  • Whole abdominal ultrasound,

  • Gastric endoscopy (with anesthesiologist),

  • ECG (ElectrocardioGraphy-heart graphy),

  • Lung X-ray,

  • Lung breathing test,

  • If needed, effort test and ECO (EchocardioGraphy)

 

After all these tests, necessary examinations are carried out by Anaesthesiology, Internal Medicine, Cardiology, Chest Diseases and Endocrine specialists. As a result of these examinations, first of all, it is 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 anaesthesia, like every patient who will undergo surgery, and it is checked whether there is an obstacle to the surgery. Relevant specialists make recommendations about the treatments to be applied before the surgery, if necessary. In this way, issues that may occur during and after the surgery are minimized.

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Do diseases such as diabetes, asthma, and blood pressure prevent gastric bypass surgery?


On the contrary, they were diseases caused and exacerbated by obesity. These diseases are a reason, not an obstacle, for bariatric surgeries.




Is a leak test performed in gastric bypass surgery?


A leak test is performed during the surgery and on the 2nd day after the operation. The purpose of leak test during the surgery is to determine whether there is an issue with the staples or a leak in the suture line. If there is a leak, additional stitches will be made on the relevant part to prevent the leakage. In addition, another leak test is performed to ensure that necessary precautions are taken in time if there is a leak before the beginning of liquid feeding.




Will there be any scars after gastric bypass surgery?


Since incisions are quite small, aesthetic results are also pretty good. These small scars will almost become invisible after a few months.




Will there be pain after gastric bypass surgery?


Since gastric bypass surgery is performed laparoscopically (closed), post-operation pain is much less compared to open surgeries. Post-operative pain can be managed by painkillers.




When does nutrition start after gastric bypass operation?


Liquid feeding is started after a leak test is performed on the 2nd day of the surgery. After 2 weeks of liquid feeding, patients will be fed with soft (puree-style) foods for another 2 weeks. Your dietitian will be in contact with you throughout this entire process.




How will be the nutrition, vitamin and mineral supplementation after the gastric bypass?


Patients are given protein supplements during the first 15 days. Various vitamin and mineral supplements are given especially in the first year. These are not standard, it is decided according to the patient's condition in routine controls.




How long does the recovery process take after the gastric bypass surgery? Is it possible to return to work immediately?


Since the operation is performed laparoscopically (closed), it is possible to stand up and walk a few hours after the operation. Patients can return to work within a week if they have an office job or their job does not require a heavy effort. Other patients should avoid from heavy work for at least 1 month.




When are the stitches removed after the surgery?


Since self-absorbing sutures are used, there is no need for suture removal. However, if non-absorbable sutures are used for a different reason, the suture is checked and removed on the 10th day which is also last postoperative control.




When can I take a bath after gastric bypass?


You can take a bath when you left the hospital. There is no problem to leave sutures open and get wet. Dry around the sutures with a clean towel after the shower and apply batikon on the sutures and wait for it to dry. There is no need to use batikon after the 10th day of operation.




What is dumping syndrome after the gastric bypass surgery?


Excessive consumption of simple carbohydrate foods after surgery may cause dumping syndrome. These are complaints that occur when the stomach is emptied too fast. Limiting simple carbohydrate in your diet may prevent dumping syndrome and help to lose weight faster. Diabetic desserts can be preferred.




Is gastric bypass surgery the definitive solution?


There is a common misconception that gastric sleeve or other bariatric surgery is the definitive solution and weight gain will never happen again. This belief may cause weight regain after the sleeve gastrectomy surgery. Permanent success of all obesity surgeries can be obtained with a good surgical operation and adequate consultation before and after the operation, patient monitoring, and the patient's lifestyle after the operation.





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Walk-through: What's next?

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First Contact

From the very first contact, we will explore your situation in-depth and start planning the path to the beauty.

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Doctor Choice

We will connect you with the best doctors in their fields for your special needs.

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Travel
Plan

We will assist you to plan your trip and give you advises on city tours.

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Transport and Transfer

Based on your operation schedule, you will fly to Istanbul on the most convenient date for you. From then on, your transfers and appointments will be arranged by us.

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Operation Day

You will be in right hands to reveal your beauty on the date of the operation.

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Home
coming

When your procedures are done, you will return home to enjoy your new life.