Rafał Mulek

Gastric bypass surgery is currently the second most common procedure after sleeve gastrectomy. Although the frequency of performing this procedure is lower than it used to be, it is still a procedure with an established position in the canon of bariatric surgery.

The operation involves the separation of a small pouch from the upper part of the stomach, called a pouch with a volume of about 50 ml, and then making anastomoses between the pouch and the intestine and between the intestinal loops in such a way that instead of the physiological one long loop of the small intestine with a length of over 5 meters, we create 3 intestinal loops:

1) a food loop about 1.5 meters long, food from a small stomach pouch enters this loop and as long as it is in this loop, it is not digested by food enzymes
2) the enzyme loop, which contains digestive enzymes produced by the duodenum, but they do not come into contact with the food taken in this loop, the length of this loop is usually about several dozen centimeters
3) the common loop, which is the remaining section of the small intestine, in this loop the typical digestive process already takes place, food is mixed with digestive enzymes and its absorption takes place. It is not without significance that the common loop begins in the second part of the small intestine, the so-called ileum. It is thanks to this that the phenomena responsible for the improvement of glucose metabolism, i.e. the treatment of diabetes, take place.

Just after the description of the above procedure, it is not difficult to conclude that it is a technically more difficult operation compared to sleeve gastrectomy. Some patients are more willing to choose this type of surgery due to the fact that the treatment effects are slightly better after the bypass surgery. In some situations, surgeons are also more willing to offer this type of surgery, especially in patients suffering from difficult-to-treat type 2 diabetes, as well as in patients whoare mainly based on sweet products. Sweets after bypass surgery are much worse tolerated by patients and eating them is often associated with sudden and unpleasant abdominal pain and diarrhea. Nevertheless, keep in mind that on the other side of the scale when making deDue to the uncertainty regarding the type of operation, a more difficult procedure, which is undoubtedly the bypass procedure, is associated with a greater operational risk resulting from the technical difficulties of the procedure.