BARIATRIC AND VASCULAR SURGEON

Gastric bypass

The gastric bypass surgery is currently second most frequently performed, just after gastric resection. Although the frequency of this surgery is smaller than it used to be, it is still a well-established procedure in the canon of bariatric surgery.

The operation involves the separation of a small tank (called “pouch”, sized ca. 50ml) from the upper part of the stomach and performing complexes between the “pouch” and bowel as well as intestinal loops in such a way that instead of a physiological one long small intestine loop of more than 5 meters long, we create 3 intestinal loops:

1) a loop of about 1.5 meters in length; to this loop gets food from the small stomach and until it remains in this loop, it is not digested by food enzymes
2) enzymatic loop, which contains digestive enzymes produced by the duodenum, but they have no contact with food; the length of this loop is usually about tens of centimeters
3) common loop, which is the remaining part of the small intestine; in this loop a typical digestion process takes place - the food is mixed with digestive enzymes and absorbed. It is important that the common loop starts in the second part of the small intestine, called “bowel”. This is due to the phenomenon responsible for the improvement of glucose metabolism, i.e. treatment of diabetes.

Just after the description of the above procedure, it is not difficult to conclude that this is a technically more difficult operation compared to the gastric resection. Some patients are more eager to choose this type of treatment because the effects of it are slightly better. Furthermore, in some situations, surgeons are more likely to suggest this type of surgery, especially in patients with difficult to treat type 2 diabetes, as well as in patients whose diets are primarily based on sweet foods. Sweets after bypass surgery are much less tolerated by patients and their food is often associated with sudden and unpleasant abdominal pain and diarrhea. Nevertheless, when deciding on the type of operation, it should be born in mind that on the other side of the scale the more difficult procedure that is undoubtedly the bypass is associated with a greater operational risk.