RYGB is one of the oldest obesity and metabolic surgery operations. Unlike sleeve gastrectomy surgery, it both restricts food intake and prevents absorption. Unlike sleeve gastrectomy surgery, a part of the stomach or intestines is not removed, but some of the intestines are disabled. RYGB has a higher weight loss and recovery rate than sleeve gastrectomy surgery. However, it is a more complicated operation since it is a longer and absorption-limiting method compared to sleeve gastrectomy surgery. Therefore, the hospital stay is longer and requires closer follow-up. As absorption is restricted, vitamin and mineral support is required throughout life after gastric bypass surgery.
Similar to sleeve gastrectomy surgery, RYGB is recommended for individuals between the ages of 18-65, with a (BMI) >40 kg/m2, having at least two previous experiences in weight control.
Another group includes patients with a BMI between 35 and 39.9 kg/m2, having obesity-related comorbidities (especially diabetes, insulin resistance, sleep apnea, etc.), and unsuccessful weight loss experience.
Like all bariatric procedures, RYGB is laparoscopically performed. The surgery has two parts. First, a small-volume pouch is created in the part of the stomach connected to the esophagus. This formed pouch occupies a volume of approximately 30-50 ml. Unlike sleeve gastrectomy, the rest of the stomach is not removed. But food does not enter this section.
In the second part of the operation, the small intestine is separated and one end is connected to the newly formed gastric sac. The other end is combined with the new digestive tract, ensuring the continuity of the bile pancreatic digestive enzymes path.
Although the duration of the operation varies according to the anatomical structure of the patient, the duration of the operation varies between one to one and half hours. However, the time to return to the service bed, together with the pre-operative preparations and post-anesthetic recovery, is approximately three to four hours. Patients generally do not need intensive care after the standard procedure. However, if necessary, close follow-up in the intensive care unit for one night may be appropriate in patients with co-morbid health problems. The patient can get out of bed four to six hours after returning to the service bed and can meet their basic needs. Complaints such as pain, nausea, and spasm on the day of surgery can be controlled with intravenous drugs.
Portion reduction is achieved with the small gastric pouch created in the basic RYGB surgery. With the gastro-intestinal connection made at the same time, the absorption of food is reduced due to the transportation of the food without using a part of the intestines. In this way, the patient gets rid of excess weight effectively by eating a regular and balanced diet.
The weight loss effect of RYGB is more effective than sleeve gastrectomy surgery. The rate of resolution of health problems accompanying obesity is higher. Long-term weight regain rates are less than sleeve gastrectomy. Although it is difficult, it is possible to return the anatomy because no part of the body is removed.
Although RYGB has a greater weight loss and health problem-solving effect, it is a more complex operation with a higher rate of complications compared to sleeve gastrectomy surgery.
It takes more time than sleeve gastrectomy and requires longer hospitalization and close follow-up.
Since it is an operation that causes malabsorption, there is a need for lifelong use of vitamins and trace elements.
A part of the stomach remains that cannot be visualized by endoscopy.
After RYGB, as in every obesity attempt, problems such as bleeding, embolism, and leakage from the stapling lines may occur. Conditions such as respiratory tract infection, wound infection, surgical site hernia, which may occur after any surgical intervention may be seen.
In the long term, the most common problems that may occur in the RYGB are the formation of gallstones, the development of ulcers in the stomach, dumping syndrome, ulcers, and obstruction in the small intestines.
During the hospital stay after the operation, intravenous serum support is given. If everything is alright in the first 24 hours after the surgery, clear liquids such as water and apple juice and food intake are started. Unlike sleeve gastrectomy surgery, there is no liquid feeding period. However, in the first four weeks, pureed food is consumed. Food containing fat and high-calorie is avoided. A healthy and balanced diet must be followed after all obesity attempts. This process is shaped by dietitians according to the current state of the patient. Protein supplements are used for the first four weeks. During this period, water consumption has vital importance. Portion restriction and attention to solid-liquid separation are essential.
Mobility is crucial in the earliest postoperative period. In-home walks are recommended for the first two weeks after surgery. After the third week, daily outdoor walks should be started on a flat and non-sloping area. In the fourth to six weeks, gradually increasing resistance exercises and weight training after the eighth week can be started. It should be kept in mind that regular exercise is essential for obtaining healthy and permanent results after surgery.
© Copyright 2021 by İnteraktif Medya
