Gastric Bypass, also known by different names such as gastric bypass and RNY gastric bypass, is one of the most frequently used bariatric surgeries.Surgery falls within the scope of obesity and metabolic surgery. In this operation, the stomach is divided into two parts, one small and the other large. The upper small stomach sac is connected directly to the small intestine. Thanks to the operation, the stomach volume is reduced, at the same time a part of the intestines is disabled. As a result of the inability of the intestines, some of the food taken is thrown out of the body without being absorbed, which prevents weight gain. Since the stomach volume is reduced in patients who have undergone surgery, the person experiences a feeling of satiety with less food, which is a situation that suppresses appetite.

What is RNY Gastric Bypass Surgery?

Gastric Bypass is a kind of stomach reduction surgery that is frequently used today. It is applied to people who cannot get results with the operation, diet and exercise, and whose weight begins to seriously affect their health. The purpose of the operation is different from that in sleeve gastrectomy surgery. While a result is achieved by shrinking the gastric capacity in sleeve gastrectomy operation, in Gastric Bypass surgery, it is aimed to achieve results both by reducing the capacity and by reducing absorption.

Why is RNY Gastric Bypass Done?

The operation allows the person to lose their excess weight. Some health problems caused by excess weight can threaten the health of the person to a great extent, and these problems can be prevented by surgery. Some of the health problems that threaten health are:

• Hypertension (high blood pressure)
• Gastro-esophageal reflux
• High cholesterol
• Infertility 
• Type II Diabetes Mellitus (Type 2 diabetes)
• Cardiovascular diseases

As a result of the surgery, people are protected from these health problems and the risks they bring. Surgery is usually performed after weight loss with diet and exercise. After the operation, diet and exercise should be supported.

Who is the operation performed for?

All of the stomach reduction surgery methods are applied to patients who meet certain conditions. Some of the conditions sought in the patient for the operation:

• Having a body mass index (BKI) of 40 and above (high obesity)
• A BKI value between 35 and 39.9, as well as the presence of some weight-related health problems accompanying the patient
• Tried non-surgical weight loss methods

Operations for stomach reduction that meet at least one of these conditions can be performed. Gastric Bypass is one of these operations. Very special documents People with a BKI value of 30-34 can also be operated on, but a decision and report should be taken according to such information.

How is RNY Gastric Bypass Surgery Performed?

The procedure is carried out laparoscopically. In laparoscopy, various instruments and a camera are placed in the abdomen for monitoring purposes through small incisions made from the abdomen. The image obtained by the camera is projected onto a screen, so that the surgeon can follow the operation without any problems.

The operation has 2 stages. In the first stage, a large part of the stomach is closed and cut off, leaving some stomach in the part that connects with the esophagus. Thus, a small stomach bag (stomach pouch) is created. The remaining stomach volume is approximately 30-50 ml. Unlike sleeve gastrectomy surgery, no part of the stomach is removed in this operation.Thanks to the created stomach bag, the food now comes here.

In the second stage, a part of the small intestines is separated and connected to the stomach sac formed. Thus, a new digestive tract is created. No part of the body is removed during the operation. The separated parts of the stomach and intestines are connected to the formed path after a certain point, and help the bile and various enzymes to participate in digestion. Since no part is removed from the body, it is possible to restore the digestive system to its original state.

There is also a variation of the surgery (mini gastric bypass), where the intestines are directly joined to the stomach bag without any divisions.

What are the Advantages and Disadvantages of the Operation?

The process has several advantages and disadvantages brought by some of the features arising from the method of its construction.

Advantages

• The patient gets rid of most of their excess weight in the long term (between 60-80%)
• The amount of food absorbed is reduced
• A part of the appetite is more easily suppressed by creating a feeling of fullness.
• Most of the weight lost after gastric bypass surgery is permanent.
• Weight regain rates are less than half of sleeve gastrectomy

In addition, with the operation, some health problems caused by excess weight can be prevented. Thus, it is ensured that people lead a healthier and higher quality life.

Disadvantages

• Fewer options when revision surgery is required
• Compared to other stomach reduction operations, the possibility of developing complications is higher, since the procedure is also performed on the intestines.
• As it reduces absorption, a deficiency in some vitamins and minerals may occur in the body, although it is rare.
• Regular diet, vitamin and mineral supplements should be applied temporarily after the operation.

Contribution of Gastric Bypass Surgery to Patient's Weight Loss

Weight loss is achieved in two ways for those who have gastric bypass surgery. Thanks to the reduction of stomach volume, the stomach becomes less nutrient-dense. Thus, a feeling of satiety is created with less food than before. Thus, the person is prevented from consuming more calories by eating more. A certain part of the patients do not pay attention to this feeling of fullness after the surgery, but because they can no longer eat anatomically, a great discomfort and vomiting sensation occurs in their stomach.

The second way that contributes to weight loss is formed by connecting a part of the intestines to the stomach sac formed by dividing and separating them. The small intestines provide the absorption of nutrients taken into the body. As a result of reducing the length of the intestine, which is actively used in digestion, the absorption rate of nutrients decreases. Unabsorbed nutrients are excreted directly from the body through feces. Thus, not all of the nutrients taken are returned to the body as calories.

Does Pain Occur After Gastric Bypass Operation?

The procedure is done laparoscopically, that is, small incisions are made in the body during the operation. For this reason, postoperative pain is less than in open surgery, but there is still a certain amount of pain. The severity and characteristics of these pains can vary from person to person. The doctor who performs the surgery and, when necessary, the anesthesia doctor, apply the necessary precautions and treatments to ensure that the patient experiences the least amount of pain from the pain, and there is a painless post-operative period.

Will there be a scar after the operation?

The procedure is carried out through small incisions. In this way, very few scars remain after the operation. These remaining scars also become invisible within a few months, and it is possible to completely get rid of the scars with various methods or cream treatment. Thus, the formation of an image in the abdomen of the patient that will spoil the aesthetic appearance is prevented.

RNY Healing Process After Gastric Bypass Procedure

The recovery period after the operation takes a shorter time compared to open surgeries. After the operation, the patient is kept under control in the hospital for a few days. After making sure that there are no complications, the patients are discharged. In case of symptoms such as unexplained fever and abdominal pain after discharge, patients should immediately consult a doctor.

The patient can return to work in 1 week if he works at a desk job, in about 1 month if he works in an actively moving job. Since these times can vary from person to person, the opinion of the doctor is very important in such cases.

How Should Nutrition Be After Gastric Bypass?

Patients should be fed soft foods for the first 1 month after the operation. The diet program carefully prepared by the doctor and dietitian should be strictly followed. Otherwise, the weight loss targeted by the surgery may not be achieved completely. Since the absorption is less than before, vitamin and mineral deficiencies may occur in the patient. Food supplements are also administered to patients to prevent such situations. It is also recommended for patients to chew food more and to facilitate digestion after the operation.

Some patients may also experience weight gain after surgery. However, this only occurs in people who do not follow a diet and have extra snacks between meals. In order to prevent such situations, patients are expected to avoid consuming extra and high-calorie snacks between the main meal programs given to them.

What is the Price of Gastric Bypass Surgery?

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