Gastric bypass surgery treats obesity by limiting the amount of food the stomach can hold and decreasing the amount of nutrients and calories the intestines can absorb. The different approaches to gastric bypass surgery use various means to shrink the stomach and form a new connection to the small intestines. Mini-gastric bypass surgery was developed to be a quicker and easier type of obesity surgery compared to the more traditional methods.
Procedure
In a modern mini-gastric bypass procedure, the surgeon uses a laparoscopic approach; instead of operating through one large incision, she inserts special instruments through several small incisions. As shown in Dr. Wei-Jei Lee's paper in the July 2005 issue of "Annals of Surgery", the surgeon staples off a long thin area along the side of the stomach to create a long tube-like structure that is less than an inch in diameter. This will be the new food pouch. The surgeon brings up a loop of the small intestine and joins it directly to the pouch in a connection called an anastomosis, bypassing about 6 feet of small intestines that join the opening of the natural stomach.
Comparison
In traditional gastric bypass surgery, called the Roux-en-Y procedure, the surgeon can use an open approach with one large incision or a laparoscopic approach. Instead of creating a new stomach tube, the surgeon staples off a small pouch of the upper part of the stomach with a volume of about 1.2 cubic inches, according to Dr. Lee. To join the new pouch to the small intestine, the surgeon must create two anastomoses, one at the new stomach pouch and one to rejoin the portion of small intestine that was bypassed.
Benefits
The laparoscopic approach of the mini-gastric bypass results in fewer complications associated with the incisions as compared to the open approach. With the laparoscopic procedure, patients have fewer post-operative infections, they heal faster and have a shorter hospital stay, according to the Mayo Clinic. Because the mini-gastric bypass involves only one anastamosis, it is a quicker and easier procedure to perform than the Roux-en-Y procedure.
Drawbacks
The anastamosis used in the mini-gastric bypass procedure brings the esophagus very close to the site where digestive juices mix with food. According to Healthier Weight, the presence of corrosive digestive juices can cause severe acid reflux in the esophagus or erode the stomach lining, causing ulcers.
Expert Insight
Dr. Lee's paper compared the outcomes of mini-gastric bypass surgery to laparoscopic Roux-en-Y surgery, following patients for 2 years after surgery. He found that the surgeries were equally effective for weight loss. Patients with a mini-gastric bypass had significantly quicker operations, shorter hospital stays, and a much lower rate of early complications after surgery. On the other hand, they had a slightly higher risk for stomach ulcer: 5 percent vs. 3 percent. In this study, there was no difference in the occurrence of acid reflux between the two types of surgery.
References
- "Annals of Surgery"; Wei-Jei Lee et al.; Laparoscopic Roux-en-Y vs. mini-gastric bypass for the treatment of morbid obesity; July 2005.
- Mayo Clinic: Gastric Bypass
- Healthier Weight: Mini Gastric Bypass
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