Gastric surgery and gastric bypass, which are among the most preferred and widely applied gastric reduction surgeries, are the operations performed for obese patients who cannot lose weight with their own efforts to achieve their ideal weight.
In this article, we will answer the questions like “What is gastric surgery?”, “How is gastric surgery done?”, “What is a gastric bypass?” and “How is gastric bypass done?” and explain the advantages and disadvantages of these surgeries in detail.
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What is Gastric Surgery?
Gastric Sleeve Surgery
Gastric surgery, which is performed by removing approximately 80% of the stomach in order to limit food intake only, is the most common bariatric surgery method.
Gastric surgery, which enables the person to eat less and reach a feeling of fullness, is mostly performed laparoscopically.
After gastric surgery, the stomach is turned into a vertical tube and the results of this surgery cannot be returned.
Gastric surgery takes an average of 1 hour, and after gastric surgery, patients start a clear liquid diet and enter a rapid weight loss process.
Those who have gastric surgery can lose approximately 70% of their excess weight within 1 to 2 years and maintain their ideal life-long form if they gain healthy living habits.
How is Gastric Surgery Performed?
Gastric surgery is an operation that takes approximately 1 hour and can be performed under general anesthesia with both open and laparoscopic methods. After the patient is given anesthesia, it is made with special tools with a camera at the end of the 4 holes in the abdomen.
During the surgery, excess parts of the stomach are removed and the abdominal cavity is filled with carbon dioxide gas to prevent damage to other organs.
Before the excess part of the stomach is cut, the new stomach is created using the stapling technique. A leak test is carried out before the operation is terminated and the operation is terminated if the leak is not detected.
What are the Advantages of Gastric Surgery?
- If patients gain healthy living habits, they can quickly lose weight and maintain their ideal form.
- As overweight is lost, a serious improvement in secondary health problems is achieved.
- After gastric surgery, patients can fill up quickly even if they consume small amounts of food.
- Since ghrelin is released in the part of the stomach that is taken out of the body, the appetite of the patients decreases after the operation.
- The pyloric valves, which control the passage of food into the intestines, are preserved during Gastric surgery. Therefore, the risk of dumping syndrome is eliminated.
What are the Disadvantages of Gastric Surgery?
- During gastric surgery, the large part of the stomach is permanently taken out of the body and this operation is irreversible.
- If the vitamin supplements are not taken after the operation and the doctor’s instructions are not followed, the balance of metabolism may be impaired.
- If healthy living habits are not gained after gastric surgery, patients may not lose weight enough or they can regain their weight. This disadvantage applies to all stomach reduction surgeries.
- When performed by experienced surgeons, the risk of leakage after Gastric surgery is minimized; however, the possibility of leakage in the stomach should be evaluated in the preoperative period.
What is Gastric Bypass?
What is Gastric Bypass
Unlike gastric surgery, the bariatric surgery method, which both restricts nutrient intake and changes intestinal functions and reduces nutrient absorption, is called “gastric bypass” or “Roux-en-Y”.
During the gastric bypass operation, a small pouch is created in the stomach first, and then the formed pouch is attached directly to the small intestine.
After gastric bypass surgery, which is completed in two stages, when the patients eat, the food they swallow goes to the small stomach in the form of a pouch created first and then goes directly to the small intestine.
How is Gastric Bypass Performed?
Gastric bypass surgery, which can be performed with both open and closed technique, but generally performed with closed technique in recent years, consists of two stages. During gastric bypass, which is made with special surgical tools through holes in the stomach, a new stomach is created in the form of a small volume pocket.
The small stomach created and the large part of the stomach is separated from each other and most of the stomach is disabled without removing it from the body. In the second stage of the operation, the small intestine is shortened.
The small intestine, shortened by an average of 50-75 cm, is connected to the new stomach formed adjacent to the esophagus. The cut part of the intestine is reconnected with the intestine approximately 70 cm ahead.
After Gastric Bypass surgery, which is completed in 1-2 hours, patients’ food intake is restricted and their nutrient absorption is reduced. Unlike gastric surgery, the parts of the stomach and intestines that are cut during gastric bypass surgery are not taken out of the body.
What Are the Advantages of Gastric Bypass Surgery?
- Thanks to gastric bypass surgery, the stomach is reduced and nutrient intake is restricted and nutrient absorption (especially fat and sugar) is reduced since the small intestine is cut. Thus, the weight loss process is accelerated.
- Since the stomach is shrunk after gastric bypass, patients start to saturate more quickly, despite eating less.
- The risk of joint disorders, sleep apnea, high blood pressure, high cholesterol and heart diseases, which can occur due to excess weight, especially diabetes, decreases.
- Since the point where the new stomach formed during gastric bypass connects to the intestine is narrower than normal, patients may experience a longer feeling of satiety.
What Are the Disadvantages of Gastric Bypass Surgery?
Like all stomach reduction surgeries, gastric bypass surgery has certain disadvantages.
- People with gastric bypass surgery may experience vitamin and mineral deficiency in the medium and long term if they do not comply with the nutrition programs. Mineral and vitamin deficiency can cause various health problems such as anemia, hair loss and decreased muscle mass.
- Nausea, constipation, and various bowel problems may occur after gastric bypass surgery.
- Hernia may occur in the operating area
- Dumping syndrome can be seen if eating fast food, because pyloric valves are not preserved in this operation.
Gastric bypass surgery does not guarantee weight loss or regain of lost weight because liquid or soft high-calorie foods can be absorbed.
For this reason, weight loss can also slow down. In gastric sleeve operations, the stomach is cut from length to length. For this reason, sometimes leaks may occur in this suture line, bleeding may occur.
Is gastric sleeve safer than bypass?
Gastric pass is more advantageous for diabetes patients than Gastric Sleeve surgery. Because the stomach connects to the small intestine, sugar absorption decreases, and intestinal hormone secretion increases, and insulin values increase.
Patients suffering from severe reflux get rid of these complaints after gastric pass. Gastric Sleeve surgery is irreversible. Although gastric bypass surgery is also said to be reversible, it is technically a difficult conversion operation that not every surgeon can or does not want to do with very high risk and complication rate.
In gastric sleeve surgery, the fundus part of the stomach is taken along with the part of the stomach that secretes the hormone ghrelin, also called the appetite hormone, because there is a very serious decrease in appetite that is noticed even in the first days in patients, which makes it easier for patients to get used to their new life after surgery.
Which surgery is better: gastric bypass or gastric sleeve?
Although tube gastric surgery is generally preferred due to lower complication rates, faster recovery, easier surgery, and cheaper, patients who are considered to benefit more from Gastric bypass are given this option. But which of the two operations is preferable depends on the patient’s condition.
The doctor decides on this. Not every surgery may be suitable for everyone. Both are successful surgeries and have effective results. For many years, the BMI and Hba1c levels of both surgeries have been monitored, serious articles have been written on the results and no very serious differences have been found.
References:
https://www.healthline.com/health/gastric-sleeve-vs-gastric-bypass
https://www.upmc.com/services/bariatrics/surgery-process/surgery-options/bypass-vs-sleeve
