Written by Mr Ali Alhamdani for Doctify

Weight loss surgery is an effective treatment for people who are dangerously obese. In this article, I will illustrate the reasons behind this.

So, what is mini gastric bypass surgery?

Mini gastric bypass surgery involves creating a smaller stomach by separating a small part of the main stomach sac to form a tubular structure. This small tubular stomach is then connected directly to the small bowel bypassing the main stomach and about two meters of first part of the small bowel.

Why is it getting so much attention?

The complications after mini gastric bypass surgery are relatively fewer than from the full gastric bypass operation. This is for a number of reasons:

  • The time required to perform the mini gastric bypass is less than that required to perform the full gastric bypass. Therefore, the chance of having complications like infections or clots in the legs or lungs is lower and this leads to a faster recovery.
  • In the mini bypass we need only one joint in the small bowel while we need two joints in the small bowel in the full bypass. This means that in the full bypass surgery higher surgical technical skills are required. This could lead to complications especially in the hands of the less experienced surgeons; accordingly, the surgical time required to learn the mini gastric bypass is less than that required to learn the full gastric bypass.

The weight loss results and the improvement of the patients’ chronic medical problems after mini gastric bypass are similar to that in the full gastric bypass.

Weight reduction has been observed to be more persistent for the people who had a mini gastric bypass in comparison to those who have a full gastric bypass. This is probably due to greater malabsorption of nutrients after a mini gastric bypass than after a full gastric bypass, which is one of the ways weight reduction is achieved through gastric surgery.

Another advantage of the mini gastric bypass operation is that if the operation fails – that is to say when the patient puts weight on again – it is more difficult to do any further surgical intervention in the full gastric bypass. The mini gastric bypass can be surgically revised relatively easier, by decreasing the length of the actively absorbing small bowel, which will lead to weight loss.

Are there any disadvantages?

Some studies show an increase in bile reflux disease after the mini gastric bypass operation while other studies deny this. Bile reflux is a condition that affects large numbers of the population. Bile – the digestive secretions formed by the liver – can be refluxed up into the stomach and oesophagus from the duodenum. Usually when that reflux happens it is accompanied by the acidic secretions of the stomach. This can lead to inflammations and ulcerations of the stomach and the oesophagus.

The symptoms are heartburn in the chest that might extend to:

  • the mouth
  • bad mouth smell
  • vomiting
  • regurgitations
  • dry cough sometimes

The chance of getting a stomach ulcer is similar in both operations and is around 4% (according to most published series at the time of writing). Lastly, each weight loss surgery procedure has its own pros and cons. The process to choose the suitable operation for the obese patient depends on:

  • patient’s dependant factors
  • surgeon dependant factors
  • operation dependant factors

The study of all those factors together by the responsible surgeon and the detailed discussion with the patient will make the right decision for that patient.

 


 

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