Mini gastric bypass surgery (laparoscopic)

  • The mini gastric bypass, also known as the single anastomosis gastric bypass, is a relatively new procedure which combines some of the properties of a gastric sleeve and a Roux-en-Y gastric bypass.

  • The upper part of the stomach is divided into a tube, similar to the top three quarters of a sleeve and then joined to a loop of intestine.

  • It is an operation that combines restriction with some malabsorption and intended to result in good weight loss and improved quality of life.

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What happens during laparoscopic mini/single anastomosis gastric bypass surgery ?

  • The mini gastric bypass, also known as the single anastomosis gastric bypass, is a relatively new procedure which combines some of the properties of a and a.

  • The upper part of the stomach is divided into a tube, similar to the top three quarters of a sleeve and then joined to a loop of intestine.

  • It is an operation that combines restriction with some malabsorption and intended to result in good weight loss and improved quality of life.

  • The mini-gastric bypass procedure is performed using laparoscopic (keyhole) technique under general anesthetic.

  • Five small incisions (between five and twelve mm in length) are made for the insertion of keyhole surgical instruments.

  • Using these instruments, the top of the stomach is stapled to form a thin tube (30ml to 50ml in size).

  • The thin tube becomes the new, smaller stomach and is completely separate from the rest of the stomach.

  • This stomach is then sewn to a loop of the small intestine, bypassing the first part of the intestine called the duodenum and approximately 150–200cm of the bowel.

  • The rest of the stomach and upper part of the small intestine remains in the body but is no longer used for food digestion.

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Post surgery?

  • Most people will stay in hospital for three or four days after surgery.

  • After the procedure you will start on clear fluids only (water, black tea, broth, juices).

  • These will need to be sipped slowly in small amounts.

  • An x-ray study is performed after the operation to check the size of the stomach pouch and ensure there is no leak from the new connection.

  • You will then remain on fluids such as water, clear soups, milk, diet cordials, or tea and coffee for the rest of your hospital stay.

  • During the next four to six weeks, while your body heals, you will gradually increase the texture and volume of the food you take.

  • Further information, including a dietary guidelines booklet, will be provided at your post-operative appointment with the dietitian.

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Does this surgery always lead to major weight loss?

  • The mini-gastric bypass procedure helps you to lose weight in two ways :

  • By dramatically reducing the amounts of food that can be eaten at any one time to a healthy portion size.

  • By decreasing the amount of calories you absorb from your food as a result of bypassing 150 to 200 cm of the upper part of the small intestine.

  • It is important to remember that surgery is a tool for weight loss. It is vital that eating behaviors are modified to get the best result from the procedure.

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What are the possible complications?

  • As with any surgical procedure, the mini-gastric bypass operation has a risk profile which is important to understand before proceeding.

  • Bleeding – This occurs in less than 1 in 100 patients after the procedure.

  • This may require blood transfusion or rarely further surgery.

  • Infection – If an infection develops it may require treatment with antibiotics and can occasionally require reoperation.

  • Leaks at the staple line – This can at times require further surgery, occasionally in the first few days after surgery.

  • If these leaks persist they can become wounds (fistula) or be persistent infections within the abdominal cavity (abscesses).

  • If this complication occurs the length of stay in hospital can extend to weeks or potentially months after surgery.

  • This can be a life-threatening problem.

  • This occurs in less than 1% of cases.

  • Damage to organs – Any laparoscopic keyhole procedure can be complicated by unintentional injury to the organs near the area of operation.

  • This may require further surgery to repair the damaged organs.

  • Blood clots – Deep venous thrombosis (clots in the veins) and pulmonary embolism (clots in the lungs).

  • Pneumonia/ chest infection.

  • Your surgical team will take all possible measures to reduce these risks, but if these complications occur, further treatment may be necessary.

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