Gastric bypass

Gastric Bypass

Gastric bypass is a procedure in which the stomach is divided into the upper small pouch of the size of an egg and the bottom section. Then the pouch is connected to the intestine and, as a result, the consumed food goes around the larger part of the stomach and intestine – they are excluded from the digestion and absorption process.

Who is the gastric bypass for?

Gastric bypass, similarly to the sleeve gastrectomy, is intended for individuals with III class obesity, i.e. with the body mass index greater than 40kg/m2 or between 35 and 40 kg/m2, if the obesity is accompanied by such diseases as: diabetes, hypertension, diseases of heart and joints or the sleep apnea.

To check your BMI use the calculator on the right side.

The course of the gastric bypass surgery

The sleeve gastrectomy is performed in a general anaesthesia. The patient is connected to numerous monitoring devices (cardiac monitor, monitor of oxygen and carbon dioxide concentration in patient’s breath, monitor of the oxygen saturation of the arterial blood), which are designed to control all necessary life parameters, and to a medical ventilator which provides breathing for a patient.

The surgery is commenced in the same way as with the sleeve gastrectomy, i.e. 5 small incisions are made on the patient’s stomach through which the laparoscopic instruments are inserted. Before the main part of the procedure the surgeon performs a visual inspection of the internal organs of the abdominal cavity. The first step of the surgery is to isolate a small pouch from the upper section of the stomach. It is performed by means of a line stapler (an instrument which simultaneously sutures the stomach and cuts between the sutures). The volume of the pouch usually equals to 20-30ml. Then a loop of the small intestine is measured out and it is connected to the small pouch (using a line stapler and absorbable sutures). Such connection is referred to as the gastrointestinal anastomosis. The larger part of the stomach, excluded from the digestion and absorption process, and first 75-150 cm of the small intestine are connected with the gastric loop passing the food from the upper section of the stomach to preserve the outlet for the digestive juices. Such connection (the gastrointestinal anastomosis) is made by means of the line stapler and the absorbable suture. After that, the intestine between the anastomoses (line staple) is excised which leaves a gastric loop of 75-150cm in length. The gastric loop, by connection to the enzyme loop, is transformed into so-called common canal (common loop) which is responsible for the digestion and absorption of the food. The suturing of the area potentially susceptible to internal hernia (Petersen’s area and intermesentric area) is an important stage of the surgery. After a thorough control of the homeostasis (inspection against bleeding), the wounds are sutured and the gas (carbon dioxide) is removed from the abdominal cavity.

Benefits of the gastric bypass surgery

  1. No foreign bodies in the organism.
  2. It is a reversible procedure.
  3. Moderate number of follow-up visits.
  4. Weight loss of up to 68% in the first year after the operation.
  5. Increased chances for the diabetes to subside.
  6. Lower frequency of the heartburn (the gastric bypass is considered an anti-reflux operation).
  7. The operation discourages the patient from eating sweet food (it makes him/her feel sick).

Postoperative risk

Each interference with the human body entails certain risk. It also applies to the gastric bypass. The laparoscopic method, however, decreases the risk. The after-effects and threats related to the surgery include, for example:

  1. Deficiency of vitamins B1, B6, B12, D3,calcium, zinc, iron, folic acid; the insufficient supplementation may involve anaemia, secondary hyperparathyroidism, neurological disorders.
  2. Leaking in the excised areas of the stomach.
  3. Clots or emboli in the blood vessels.
  4. Dumping syndrome (sensations of full stomach, fatigue, increased heart rate, hyperhidrosis)– occurs after the consumption of monoses (e.g. very sweet tea), high-calorific liquids.
  5. Frequent bowel movements and unpleasant odour of stool. It may be caused by diet rich in fat. With time, the frequency of bowel movementsdecreases.
  6. Infection of the postoperative wounds and the operated area.
  7. Narrowing of the gastrointestinal anastomosis.
  8. Marginal ulceration in the anastomosis area.
  9. Damage to the spleen, liver and intestine.
  10. Heartattack,cardiovascularfailure.
  11. Impaired wound healing, hypertrophic scars, hernia.
  12. Intestinal obstruction possible even many years after the surgery.
  13. Protein malnutrition.
  14. Tendency to alcoholabuse.

Partial success of the surgery (loss of 50% of the overweight after 5 years) is usually associated with consumption of high-calorific liquids and must not be regarded as a postoperative complication.

After the surgery it is recommended that the patient strictly follow the diet and take multi-vitamin products. Due to the risk of deficiency of vitamins and minerals it is necessary to undergo medical examination and laboratory tests after 7 days, 1, 3, 6, 9, 12, 18 and 24 months, then once a year.

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  • Łarysa P.

    Hello everyone, I would like to sincerely thank you for a chance of a new, better life. I have never met such polite and understanding doctor as Piotr Myśliwiec, who also spares no time for his patients. He would always comprehensively explain the aspects which I did not understand. Thanks to the procedure which he…

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  • Grażyna L.

    On 4th May 2016 doctor Piotr Myśliwiec gave me a new, better life. During the first visit he has already showed his big heart for patients. He explained to me the stages of the procedure, the possible effects but also potential problems. He was talking to me and dispelling all my doubts with a smile…

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  • Robert C.

    This September I have undergone a gastric bypasssurgery performed by doctor Piotr Myśliwiec. For a few weeks hehas been patiently and calmly explaining to me the course of the procedure. After the surgery he visited me a few times to monitor my recovery. I was released home the next day. After 2 months I have…

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  • Anonymous

    Before the surgery I weighed 105 kg though I was only 158 cm tall. The obesity I suffered from deprived me of my confidence. I abandoned active life, a lot of everyday activities caused great difficulty to me. The problem with finding clothes in the right size also contributed to my low self-esteem and deteriorating…

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  • Anonymous

    Within 10 months after the gastric bypass I have lost over 50 kg (from 140 kg to 85 kg)!!! Doctor Piotr Myśliwiec a real wonderworker, the impossible became possible! The doctorhas not only a deep knowledge and expertise, but also kind and matter-of-fact attitude towards patients. I am grateful tothe doctorfor the “second youth”. The…

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  • Anonymous

    Piotr Myśliwiec, M.D., Ph.D, has completely changed my life:) He is friendly, warm and always smiling – which is really rare in doctors – but, most importantly, he is a very good surgeon. The sleeve gastrectomysurgery which I underwent 1.5 year agodid not involve any complications or postoperative pain but, what is the most significant…

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  • Piotr
    Piotr, 30 age

    My problems with obesity started when I was 2 years old and suffered a serious body dehydration. From that moment on I began to gain weight. My picked on me for many years which was particularly nasty, especially during the school years. As a 7-year-old I weighed over 60 kilograms… I started to suffer from…

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