Mini gastric bypass
What is it and why is it performed?
It is a weight loss (also called bariatric) surgery designed to reduce the size of your stomach and also the length of your gastrointestinal tract. It is performed in order to help you lose weigth. It is a minimally invasive surgery, which means that there are no big incisions and no big scars.
What happens during mini gastric bypass?
This surgery is performed under general anaesthesia, so you will be sleeping during the whole procedure and will not feel anything. Firstly, a surgeon will make several small incisions in your abdomen. In order to visualize the abdominal cavity, he or she will insert a small flexible camera through one of these incisions. This camera helps to visualize the operating field by transmitting views from the abdominal cavity to a video screen. Other incisions will be used to insert surgical instruments (scissors, graspers, needle holders, etc.). When everything will be set, the surgeon will divide your stomach into two parts. The smaller part, that is connected to the esophagus, will be your new ‘mini‘ stomach. It will be able to contain just a small amount of food, so you will feel full sooner while eating. The next step is bypass formation. The surgeon will connect your small intestine to your ‘mini‘ stomach. As a result, the food will bypass some parts of your gastrointestinal tract (the bigger part of your stomach, duodenum and a part of jejunum) and go straight from the new stomach to the small intestine. In this way, fewer calories will be absorbed. Finally, the surgeon will remove all the instruments and close the incisions.
Are there any concerns?
Although it has been more than twenty years since the first mini gastric bypass was performed, several concerns have been expressed. These include higher risk of symptomatic biliary reflux, oesophageal and gastric cancer and malnutrition. However, recent studies have shown that mini-gastric bypass is associated with even lower rate of postoperative reflux than other bariatric surgeries. Also, there is a lack of strong evidence that it is associated with cancer.
Is it superior to other bariatric procedures?
Mini gastric bypass is becoming more and more acknowledged because of its effectiveness, convenient technical approach and safety. Comparative analyses have shown that mini gastric bypass could be even more effective than Roux-en-Y gastric bypass, which is the gold standard of bariatric surgery. According to clinical studies, mini gastric bypass enables patients to lose as much as 72,9 % of their excess weight. In addition, almost all patients (that would be 95 % in numerical expression) manage to get rid of more than a half of their excess weight with the help of this procedure.
Moreover, there are technical advantages. Mini gastric bypass surgery changes the anatomy of gastrointestinal tract in two different ways: reduces the capacity of a stomach and creates a shorter pathway for food. As a result, you lose weight because of several different processes (early satiety, hormonal changes, less calories). Furthermore, mini gastric bypass takes less time to perform, is less traumatic to your body tissues and is appreciated for its technical simplicity. Also, it is easily reversible if needed. Last but not least, it is associated with fewer major complications such as leaks, fistulas, bleeding and strictures.
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