The gastric bypass or stomach bypass is one of the surgical techniques for treating morbid obesity. Alongside purely restrictive techniques, such as gastric banding, and largely malabsorptive techniques, such as Biliopancreatic Derivation by Scopinaro, this is a combined technique.
As with a purely restrictive intervention such as the adjustable gastric band, this surgery is largely a restriction of the food intake, with reduced digestion a less important factor. However, the long-term results are noticeably better than those for purely restrictive surgery. This is due to reduced food intake, a reduced feeling of hunger and the existence of “dumping”(a feeling of being unwell) when ingesting sugars.
Practically every case involves a laparoscopic operation or keyhole surgery. Via small incisions of 0.5 to 1 cm, the surgeon makes 5 to 7 trocarts (operating canals).
A small stomach pouch of about 15 ml is separated from the stomach and sealed with staples. With this technique the stomach and the small intestine are left intact! The small intestine is then cut 50 cm from the point at which it starts. The bottom part of the small intestine is then linked to the small stomach pouch. This can be done by means of staples or stitches. The top part of the small intestine is then rejoined to the other part about 100 cm from the stomach. The surgeon may decide to alter the length of these intestine segments.
As a result the stomach and duodenum are bypassed, so that food no longer passes through the stomach. The food does not mix with gastric, gall and pancreas juices until it reaches the point where the 2 small intestine loops meet each other.
The gastric bypass largely works through reduced food intake (restriction). This is achieved in several ways.
- Quick feeling of fullness: the small stomach pouch causes an early feeling of fullness, which inhibits the intake of food.
- Reduced feeling of hunger: the feeling of hunger reduces appreciably. This can be explained by the fact that the stomach pouch is separated from the stomach, as a result of which less of the hunger hormone (ghrelin) is produced.
- Dumping syndrome: this is an uncomfortable feeling, which is stimulated by the food in the small stomach pouch going directly to the small intestine. This feeling tends to be caused by eating sugars and by eating too quickly. Dumping stops a lot of patients from eating sweets, which is one of the reasons for weight gain after purely restrictive operations, such as gastric banding and gastroplasty. This dumping syndrome differs from patient to patient and appears to increase in the years after surgery
- 4 taxi trips between airport, hotel and hospital
- 5 nights stay in a hotel near the hospital for 2 people. This means you stay 1 night before the procedure at the hotel. Then 2 nights at the hospital. And again 2 nights at the hotel.
- Your personal coach visits you the first evening in the hotel to explain the schedule, answer your questions, handle finances and you 'll receive his visitcard in order to reach him 24/7
- Consultation with your surgeon in hospital during the morning before OR
- Visit from your personal coach to give personal advice and addresses of our clinics in your home country if necessary (aftercare)
