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Gastric Bypass Surgery

Gastric Bypass Surgery

Gastric bypass is one of weight loss surgical procedures that helps you lose weight surgically by changing the anatomy of your stomach and intestine

You must have heard about gastric bypass as a weight loss surgical procedure. Laparoscopic Roux-en-Y gastric bypass (LRYGB) is one of the most effective types of bariatric surgical techniques and weight loss surgeries in Turkey.

The first gastric bypass procedure was performed in 1994, and the method of performing this type of operation has developed over time with the emergence of new surgical technologies, to become safer and more effective compared to the older techniques used in the past.

Gastric bypass is a great option when compared to the rest of weight loss procedures, as it results in more weight loss than adjustable gastric banding or gastric sleeve procedures do.

The advantage of this operation is that the weight loss it induces remains constant over time and the patient is less likely to regain weight after they have lost it.


How does gastric bypass help you lose weight?

Gastric bypass surgery helps obesity patients lose weight by both restricting the amount of food a person consumes and reducing the total amount of calories absorbed by the gastrointestinal tract.

Gastric bypass procedure also induces some hormonal and physiological changes when food doesn’t pass through the duodenum –first part of small bowel- , as it decreases ghrelin levels, which are the hunger hormone, and increases the levels of leptin hormone, which is the satiety hormone, thereby decreasing the feeling of hunger and suppressing appetite, restricting the amount of food the patient consumes.

Who is a good candidate for gastric bypass?

The gastric bypass procedure is used in cases of severe obesity, but because this surgical procedure is a major surgery that can pose some risks and side effects, the decision to perform this procedure is done after weighing possible benefits and risks.

The obesity patient needs to meet some criteria to qualify for gastric bypass, and these criteria depends upon body mass index, and the clinical assessment of the patient health condition, according to the following:

  • A body mass index of more than 40 kg/m2, whether there are complications of obesity or not.
  • A body mass index of 35-40 kg/m2, with the presence of serious complications of obesity, such as diabetes, sleep disorders, snoring, high blood pressure, and coronary artery diseases, among others.
  • A body mass index of 30-35 kg/m2, with difficulty controlling blood glucose levels or the presence of metabolic syndrome.

Patients qualify for gastric bypass based on the above criteria are evaluated using a comprehensive, multidisciplinary system, usually performed by a bariatric surgeon, a dietitian, and a psychologist.

gastric bypass

Is gastric bypass better than other bariatric procedures?

It is true that all weight loss processes lead to weight loss to one degree or another, but there are some anatomical or physiological factors that can encourage gastric bypass as an option to manage obesity, and there are some other factors that experts consider an absolute contraindication to perform gastric bypass.

For example

  • Gastric bypass results in a better tissue response to insulin in a greater degree than other bariatric procedures, and this may be considered a reason to choose it over other procedures, especially for type 2 diabetes patients, fatty liver patients, people with metabolic syndrome, or polycystic ovary, as the common factor between these diseases is the presence of insulin resistance.
  • It is worth mentioning here that gastric sleeve and gastric bypass procedures improve symptoms of type 2 diabetes equally in the near term, but gastric bypass is more effective in the long run.
  • In patients with chronic esophageal reflux disease “GERD”, especially in the presence of complications, gastric bypass is the procedure of choice, and gastric sleeve is not preferable in this case.
  • Conversely, in patients who use nonsteroidal anti-inflammatory drugs NSAIDs or steroids on a regular basis, because of certain diseases, or chronic pain, as well as patients with inflammatory bowel disease, gastric bypass is not a good option to manage obesity, and gastric sleeve is the procedure to go for in those cases.

Gastric Bypass Technique: How it is done?

  1. Gastric bypass operation is performed under general anesthesia. The surgeon opens a few tiny openings, 3 cm long each, surgical instruments are inserted through these opening along with a camera that has a strong illumination device to enhance vision, the surgeon sees what the camera feeds through an electronic screen, Abdominal cavity is insufflated with inert carbon dioxide to facilitate the surgical tools motion inside the abdomen.
  2. The surgeon first divides the top of the stomach and isolate it from the rest of stomach, leaving a small pouch of about 30 ml in volume, dramatically decreasing the amount of food the stomach can accommodate.
  3. The surgeon cuts into the middle of small intestine, and connect the free bottom end of the cut bowel directly to the small pouch of the stomach, so that the food passes through the stomach, directly to the middle of the small intestine, bypassing the first part of the intestine.

What are the possible postoperative complications associated with gastric bypass?

  • The patient's condition is closely followed, and any pain or nausea is treated.
  • The patient is prescribed vitamins, minerals and nutritional supplements after the operation.
  • In the first period after the operation, the patient may experience some side effects as a result of rapid weight loss, such as: body aches, fatigue, dry skin, and other symptoms.

Is gastric bypass surgery effective?

Gastric bypass surgery helps severe obesity patients to lose significant weight permanently, as the percentage of lost weight can reach about 60% of extra body weight within two years, in addition to this it helps patients improve the quality of their lives and their ability to do many activities.

Moreover, gastric bypass may treat or prevent several diseases, such as:

  • Gastroesophageal reflux disease
  • Heart disease
  • Hypertension
  • High cholesterol
  • Sleep and snoring disorders
  • Type II diabetes mellitus
  • Cerebrovascular accidents
  • Infertility

Cost of gastric bypass

Turkey has become famous in medical tourism in general, and bariatric surgeries in particular in terms of reasonable price and satisfactory results.

You may contact us to obtain an assessment of your condition and accurate medical advice.

Gastric bypass for Diabetic

Doctors aim at this process to help the small intestine get rid of excess glucose for diabetics.

Gastric bypass surgery often improves symptoms of type 2 diabetes, even before weight loss begins.

"The main principle is that after a stomach bypass, the intestine becomes the most important tissue to use glucose and this reduces blood sugar levels," said Dr. Nicholas Sotiropoulos, a researcher at the Endocrinology Department at Children's Hospital in Boston and the Boston College of Medicine.

Post-gastric bypass

Most gastric bypass operations are laparoscopic, which means the surgeon makes small incisions.

This leads to shorter recovery times.

Most people stay in the hospital for two or three days, and they return to the activities they are used to within 3 to 5 weeks.

It will not be allowed generally to eat for a day or two until the stomach and digestive system heal and then you will follow a specific diet for a few weeks, we will talk about it later in this article.

Vitamins after the gastric bypass

Vitamins and nutritional supplements should be taken daily to prevent malnutrition.

Doctors recommend that gastric bypass patients take vitamins and calcium with vitamin D, iron, vitamin C, and vitamin B12.

SASI (single anastomosis sleeve ileal) bypass

SASI is one of the most recent types of gastric bypass operations, and it has been called by this name because it is through which the path of food entering the stomach is divided into two tracks:

  • The first track is the usual food route.
  • The second food pathway is from the stomach to the end of the small intestine directly, bypassing a large portion of the bowel space.

Laparoscopic SASI bypass involves performing two simultaneous procedures, namely gastric sleeve, and gastric bypass, where the process is divided into two stages:

  • The first stage: It is called (gastrectomy), in which approximately 80% of the stomach volume is cut, including the interior of the stomach.
  • The second stage: It is called (gastric bypass) that takes place in conjunction with the first stage, in which a link or path is made between the stomach and the small intestine, resulting in determined and reduced food amount, which leads to a reduced amount of food absorbed from the body.

Diet after the gastric bypass

Gastric bypass reduces stomach size and changes the way food enters the intestine.

After surgery, it is important to have adequate nutrition while maintaining weight loss.

Your doctor will likely recommend:

  • Eating and drinking slowly, take at least 30 minutes to eat your meals and a gap of 30 minutes before or after each meal to drink fluids.
  • Maintain small meals: eat several small meals a day, you can start with six small meals a day, then move to four meals, and finally, following a regular diet, three meals a day.

Each meal should include about half a cup to a cup of food.

  • Drinking fluids between meals: To avoid dehydration, you will need to drink at least 8 cups (1.9 liters) of fluids per day, but drinking plenty of fluids at mealtime can make you feel extremely full and prevent you from eating enough nutrient-rich food.
  • Chew the food well: the new opening that leads from your stomach to the small intestine is very narrow and can be blocked by larger pieces of food. Blockages prevent food from leaving your stomach and can cause vomiting, nausea, and abdominal pain.
  • Take small bites of food and chew them to pureed strength before swallowing.
  • Focus on protein-rich foods: Eat these foods before eating other foods.
  • Avoid foods high in fat and sugar: These foods travel quickly through your digestive system and cause dumping syndrome.
  • Take recommended vitamin and mineral supplements: After surgery, your body will not be able to absorb enough nutrients from your food, you will likely need to take a multivitamin supplement every day.

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