The gastric bypass is frequently held as the ‘gold standard’ of bariatric surgery as it is the most frequently performed procedure worldwide with the best, long-term results. But as with every reward there are potential risks involved, and the gastric bypass is no different. This may be one of the reasons why the mini gastric bypass has seen an increase in popularity. Let’s explore this further.
What is a gastric bypass?
The gastric bypass (roux-en-y gastric bypass, RYGB) works in two ways to help a patient lose weight. It considerably reduces the size of the stomach, which reduces the volume of food that can be consumed. As the operation essentially ‘bypasses’ the stomach with the early passage of food into the intestine, the hormonal component helps appetite suppression, making weight loss relatively straightforward for the great majority of people.
What is a mini gastric bypass?
The ‘mini’ gastric bypass, also known as the One Anastomosis Gastric Bypass (OAGB), Single Anastomosis Gastric Bypass (SAGB) is similar to a Roux-Bypass but has a somewhat simpler construction. The first part involves creating a narrow gastric tube or pouch, similar to what happens with a roux-bypass, however it’s often a little longer to help prevent post-op bile reflux. The second part involves joining this “new stomach” to a loop of small bowel, bypassing 150-250 cm. The amount of small bowel bypassed is usually longer than what is bypassed for roux-bypass.
Risks vs Benefits of Gastric Bypass Options
As a mini gastric bypass is a simpler procedure and can be performed in a shorter amount of time than the traditional roux-en-y bypass, the risks of this bariatric surgery are lower as are potential complications during surgery. A mini bypass has also demonstrated a lower risk of obstruction of the small bowel compared to a standard bypass.
The mini gastric bypass also comes with its own potential problems following surgery, such as a risk of suffering from nutrient deficiencies if you don’t keep up with your vitamin and mineral supplements – like with any bypass this is a requirement for the rest of your life.
While a mini gastric bypass has lower risks of abdominal pain and bowel blockages, there is a higher risk of reflux (although less risk than what we see with sleeve gastrectomy) and possibly a bigger risk of stomach ulcers than roux-bypass if patients drink alcohol, smoke cigarettes or take anti-inflammatory medications. The more small bowel that is bypassed during the procedure the greater the chances also of malnutrition, diarrhoea and foul smelling gas.
Finding the right bariatric surgeon
The mini gastric bypass has not been performed as long as the roux-en-y gastric bypass, and although it has delivered excellent weight loss results so far, the long-term success can’t be measured as efficiently as the standard operation.
Not all bariatric surgeons are experienced in performing the mini gastric bypass, so you may find it challenging to find a surgeon that has high case load experience in this area, delivering safe and effective obesity treatment.
A/Prof Michael Talbot at Upper GI Surgery has been performing complex bariatric surgery for over 20 years and the clinic has treated over 5,000 patients during this time. Dr Talbot has extensive mini gastric bypass operating experience and offers it as one of many different surgical treatment options for obesity.
0 Comments