Written by Dr. Alapati
All the types of gastric bypass procedures have long-term effects. The symptoms of a lot of health conditions brought about by morbid obesity are lessened after the surgery. Gastric bypass changes patients’ lives and a new diet that helps with the smooth functioning of the changed digestive system must be obeyed. The following are the different types of gastric bypass surgery.
Roux-en-Y
This type is generally the typical type of gastric bypass procedure done in the United States. First, a small pouch is made by attaching a section of the stomach together or through banding it vertically. This surgery will limit food consumption. Then, a Y-shaped part of the small intestine is joined to the small pouch to permit food to bypass the duodenum and the first section of the jejunum.
In this way the food that enters through the esophagus then into the small pouch and then out via the lower portion of the small intestines known as jejunum and lastly to the colon or the large intestines.
This will lessen absorption of nutrients and calories. This surgical operation can now be performed through a laparoscope, a thin tube-like instrument used to look inside the stomach. This includes small incisions and usually has a faster healing time.
Extensive gastric bypass
This surgical operation is sometimes called Biliopancreatic diversion. This is a more complicated and more mutilating type of gastric bypass because it involves total removal of the large part of the stomach. Contrary, to the other types gastric bypass surgeries in this surgical operation approximately ½ of the stomach is totally removed. Bear in mind that not the entire stomach is removed. This can be performed either vertically or horizontally, which is typically what happen when making the small pouch.
First, the lower part of the stomach is removed. Then, the small pouch that stays is attached directly to the last segment of the small intestine. Therefore, this completely bypasses both the duodenum and jejunum. Even though this surgery effectively promotes weight loss, it is not commonly performed since there is a high risk for lack of nutrition.
Gastric bypass surgery that results to lack of absorption and limits food consumption produces more weight loss compared to surgical procedures that only reduce food consumption. Patients undergo bypass surgery usually lose 2/3 of their extra weight in 2 years.
Mini-Gastric Bypass Surgery
This type of surgery is commonly done laparoscopically and is usually done within 30 minutes. Contrary to the usual gastric bypass, the mini-gastric bypass surgery does not make a small pouch. It fastens the stomach into a tube on the side of the stomach, which is directly connected to the bottom part of the intestines instead.
The procedure uses small incisions of the intestines thus the name mini-gastric bypass. It has the benefit of faster healing and shorter hospital stay. It is even believed to be more effective than Roux-en-Y.
Fobi Pouch
The Fobi Pouch type both limits food intake and limits absorption of calories and nutrients. This procedure makes about one ounce vertical and banded pouch, fully separated from the left over stomach and attached to the small intestine similar to a Roux-en-Y procedure with the insertion in the jejunum.
A vertical pouch is much less susceptible to stretching than the traditional horizontal pouch. The band at the opening of the pouch implements a small permanent opening, reducing the time it takes for food to enter inside the pouch and, thus, reducing the number of food that can be eaten every day. Separating the pouch totally away from the remainder of the stomach and inserting the jejunum between the edges lessens the possibility of the stomach going back together and invalidating the gastric bypass. Fobi Pouch can be accomplished proximally, medially and distally based on the starting weight of the patient. Also, Fobi Pouch has less complications and an effective weight loss ranging from 70% to virtually 100%. There is also less chance of regaining weight.
Plastic Surgery
This type of gastric bypass can involve cosmetic and reconstructive surgical procedures. It can be used by a lot of patients following weight-loss surgical operation after the weight loss has become stable, typically around 12 to 18 months. This can be done by a plastic surgeon.
Distal Gastric Bypass
This surgical procedure restricts food intake and has a greater malabsorption compared to other types. The gastric bypass surgery can be changed to modify food absorption, by moving the Y-connection distally. This will successfully shorten the small intestine available for food absorption. The weight loss result is then caused by both a very small stomach, which restricts food intake, with lack of nutrients absorption, decreasing the caloric consumption even more. Patients have improved bowel movement frequency and more fat in their bowel movements. This will make the smell of gas extremely strong, which can bring social embarrassment. Absorption of calcium will also be difficult, in addition to vitamins absorption especially the fat soluble vitamins A, D, and E. Due to this taking daily vitamin supplements is a must and not following the approved diet and supplement treatment can bring extreme nutritional deficiencies in some of the patients. There is also a noted increase of ulcers after this surgical operation among patients.
This procedure is usually confused with the Roux-en-Y. However, this is actually much similar to the extensive gastric bypass procedure. Distal gastric bypass tries to unite restriction and malabsorption. There is a creation of a small stomach pouch and more than half of the small intestine is bypassed. This caused a higher possibility of protein and calories malabsorption and ulcer formations compared to extensive gastric bypass. Luckily, in this surgical procedure, the small stomach pouch will keep on increasing in size as the patient is encouraged to eat a lot as time goes by.
These are all of the most common types of gastric bypass. You can discuss it more with your surgeon to have an informed choice so that you can choose wisely what you think will be the best for you.
For more information see Gastric Bypass Surgery.