This is both a restrictive and a malabsorbtive procedure whih produces the greatest metabolic effects but also has the potential of having more long term complications in the form of nutricional deciciencies. The success of this method is on average 60 – 70% EWL.
The success of this method is about 65%. This procedure has very good results in reducing comorbidities such as diabetes mellitus, leading to an increasing preference for this method where speedy resolution to comorbidities is required. Complete disappearance or significant improvement in diabetes type 2 is observed in up to 85%!
In essence, the operation consists of the separation of a small part of the stomach cardia (volume of about 20-50 ml) and then connection to the small intestine in the form of a Roux en Y (The Roux en Y construction includes two limbs (in a “Y” formation). One limb or loop is the one food and other oral intakes flow through; the other is for bile and other drainage. The surgery is defined as mixed; restrictive and malabsorptive. If the loop is short (proximal) (up to about 75 cm), the malabsorptive effect is less, causing less long term problems, which is preferred. A “long-limb” (distal) option is available, where the alimentary loop reaches 150 cm or more, causes more malabsorption, but has more associated problems.
Complications can occur, obviously related to construction of the bypass, like the gastric sleeve, complications are mainly haemorrhaging staple lines and leakage in the staple lines. Other late complications that we can identify are gastric fistulas, ulcers at the connection of the small stomach to the small intestine, or narrowing of the connection.
The malabsorption component of this operation can increase the efficiency of the op when compared with purely restrictive operations (although recent studies show that there is a similar effect with the sleeve gastrectomy), but brings side effects in the form of deficiency of certain micronutrients such as iron, vitamin B12, vitamin D and others. In the postoperative period is therefore necessary to constantly monitor these nutrients and substitute with vitamin tablets (get your gp to give you regular blood tests).
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This procedure is better for patients with a larger BMI or patients that suffer from severe acid reflux, due to the possibility of severe malabsorption of vitamins over the long term.
- A higher BMI (over 50)
- A very sweet tooth (dumping syndrome is common which can be a very big deterrent)
- Patients that suffer from acid reflux
- Patients with Diabetes type II. Evidence shows that 81% of type II diabetics get remission with this procedure (although the sleeve is said to be almost as effective)
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A medical form needs to be filled in to send to our surgeon to see if you qualify for surgery. Please fill it in and provide as much detail as possible. Once we have received this form we can usually confirm your surgery within 48 hours.