Mini Gastric Bypass vs Roux-en-Y Gastric Bypass

Mini Gastric Bypass vs Roux-en-Y Gastric Bypass: Understanding Your Weight Loss Journey

Embarking on a weight loss journey is a deeply personal experience. As obesity rates continue to rise globally, many people are turning to surgical solutions to help achieve substantial weight loss and improve their overall health.

This blog post addresses this concern and offers a comprehensive overview of Roux-en-Y Gastric Bypass (RYGB) and Mini Gastric Bypass, two popular weight loss surgeries. It discusses the procedures, benefits, and potential risks associated with each option. The article also explores the criteria for eligibility for bariatric surgery in India and offers guidance on choosing a qualified bariatric surgeon in Delhi. Ultimately, the goal is to empower individuals considering weight loss surgery to make informed decisions based on their specific needs and goals.

Introduction

When considering weight loss surgery, understanding the available options is crucial. Two common procedures, Roux-en-Y Gastric Bypass (RYGB) and Mini Gastric Bypass, offer significant weight loss benefits but differ in their techniques and outcomes.

On average, people who undergo gastric bypass surgeries, lose 70 to 80% of excess body weight. However, it’s important to remember that these surgeries require a lifelong commitment.

This blog will delve into the details of 2 such procedures, helping you make an informed decision about which is best suited to your individual needs.

What is Roux-en-Y Gastric Bypass (RYGB) Surgery?

Roux-en-Y Gastric Bypass (RYGB) is a more traditional weight loss surgery that involves creating a small stomach pouch and bypassing a portion of the small intestine. This rerouting of the digestive system leads to reduced food intake and absorption, resulting in significant weight loss.

How RYGB Works:

Stomach pouch creation: The upper portion of the stomach, near the oesophagus, is stapled to create a small pouch that holds less food.
Intestinal rerouting: The lower section is attached directly to the new stomach pouch, creating a pathway called the “roux limb.” The upper section of the small intestine, which carries digestive juices, is then attached further down the digestive tract, to the end of the roux limb. This allows food to bypass the lower stomach, the duodenum (the first part of the small intestine), and a portion of the small intestine itself.
Reduced food intake and absorption: The rerouted digestive system limits the amount of food that can be consumed at once and reduces the absorption of nutrients.

Benefits of RYGB Surgery:

Significant weight loss: Patients often experience substantial weight loss within the first year of surgery.
Improved health outcomes: RYGB can address obesity-related health conditions such as diabetes, high blood pressure, and sleep apnea.
Long-term weight loss maintenance: Many individuals who undergo RYGB surgery are able to maintain their weight loss over the long term.

What is Mini Gastric Bypass Surgery?

Mini Gastric Bypass, also known as one anastomosis gastric bypass, is a less invasive procedure compared to the traditional Roux-en-Y Gastric Bypass. It involves creating a small stomach pouch to limit food intake and rerouting part of the small intestine to reduce nutrient absorption.

How Mini Gastric Bypass Works:

Stomach pouch creation: Similar to RYGB, the surgeon makes your stomach smaller by stapling and reshaping it into a long, slender pouch.
Direct connection: A new path is created for the food to pass through. A section of your small intestine is connected to the new stomach pouch. This bypasses the lower part of your stomach, the duodenum, and some of your small intestine.
Reduced food intake and absorption: The rerouted digestive system limits the amount of food that can be consumed and reduces the absorption of nutrients.

Benefits of Mini Gastric Bypass Surgery:

Potential Reversibility: Unlike some weight loss surgeries, Mini Gastric Bypass is potentially reversible due to its simpler design.
Reduced risk of obesity-related comorbidities: Mini Gastric Bypass can help address other health conditions associated with obesity, such as high blood pressure and sleep apnea like in RYGB.
Less restrictive: Mini Gastric Bypass may allow for a more flexible diet compared to RYGB.

Which Gastric Bypass Surgery is Right for You?

The decision between Roux-en-Y Gastric Bypass and Mini Gastric Bypass depends on various factors, including:

Individual health goals: Consider your desired level of weight loss and any specific health conditions you want to address.
Medical history: Discuss any existing medical conditions or risk factors with your surgeon.
Lifestyle factors: Consider your dietary habits, exercise routine, and overall lifestyle.

There are minor differences in these two procedures. With different advantages and disadvantages, the best outcome will depend by making an informed choice in consultation with your bariatric surgeon.

Who is Bariatric Surgery for?

Bariatric/metabolic surgery should be considered a treatment option for acceptable Indian patients with a BMI ? 35 kg/m², with/without the presence of any obesity-related co-morbidity.

Bariatric/metabolic surgery should be considered a treatment option for acceptable Indian patients with a BMI ? 30 kg/ m², in the presence of two or more obesity-related co-morbidities.

Bariatric/metabolic surgery should be considered as a non-primary treatment option for acceptable Indian patients with a BMI ? 27.5 kg/ m², with uncontrolled type 2 diabetes despite optimum medical management.

Any bariatric/metabolic surgery for an Indian patient with a BMI < 27.5 kg/ m² should be strictly performed under an experimental study protocol with prior ethics committee approval and informed consent from the patient.

Bariatric/metabolic surgery should be considered as a treatment option for acceptable Indian patients with central obesity with a waist circumference ? 80 cm in females and ? 90 cm in males along with type 2 diabetes and other obesity-related co-morbidities.

Bariatric/metabolic surgery may be advised as a treatment option for acceptable Indian patients who qualify for the above BMI criteria if they are ? 18 years of age. It may be advised as a treatment option to patients younger than 18 years of age under special circumstances with the approval of a multi-disciplinary team constituting a pediatrician, endocrinologist, dietician, psychologist, and a bariatric team including a bariatric surgeon. Attainment of puberty and completion of skeletal maturity must be taken into account for this patient population when considering the option of surgery.

Bariatric/metabolic surgery should be advised as a treatment option for acceptable Indian patients who qualify for the above BMI criteria for patients up to 65 years of age. Bariatric/metabolic surgery may also be recommended for patients ? 65 years of age if they are medically fit, and the benefits of surgery outweigh the risks.
All patients who are advised of bariatric/metabolic surgery as a treatment option should be motivated to enter a long-term weight management program and should be committed to life-long follow-up.

Long-term weight management programs and follow-ups must be provided by all bariatric teams.

Choosing a Bariatric Surgeon in Delhi

It’s essential to consult with a qualified bariatric surgeon who can assess your individual needs and recommend the most appropriate procedure. A bariatric surgeon can provide personalized guidance, address your questions and concerns, and help you make an informed decision.

Ready to take the next step towards a healthier you?
Here’s a quick checklist to help you find the perfect fit:

Experience and qualifications: Look for a surgeon with extensive experience in performing weight loss surgeries.
Board certification: Ensure the surgeon is board-certified in bariatric surgery.
Hospital affiliation: Consider the surgeon’s affiliation with reputable hospitals in Delhi.
Patient reviews and testimonials: Read reviews and testimonials from previous patients to get a sense of the surgeon’s expertise and patient satisfaction.

Preparing for Weight Loss Surgery

If you decide to undergo weight loss surgery, it’s important to prepare for the procedure and the recovery process. This may involve:

Making lifestyle changes: Adopting healthier eating habits and increasing physical activity can help you prepare for surgery and improve your overall health.
Undergoing pre-operative evaluations: You may need to undergo various medical tests and evaluations to assess your suitability for surgery.
Following pre-operative instructions: Your surgeon will provide specific instructions to follow before the procedure.

Recovery and Post-Operative Care

Recovery from weight loss surgery typically involves a hospital stay of several days, followed by a period of at-home recovery. During this time, you will need to follow your surgeon’s instructions for wound care, medication, and dietary restrictions.

Long-Term Follow-Up

After surgery, it’s important to attend regular follow-up appointments with your bariatric surgeon. These appointments will help monitor your progress, address any concerns, and ensure that you are receiving the necessary support for long-term weight loss maintenance.

Conclusion: Mini Gastric Bypass vs Roux-en-Y Gastric Bypass

Both, Roux-en-Y Gastric Bypass and Mini Gastric Bypass, surgeries offer significant potential for weight loss and improved health outcomes. By understanding the differences between these procedures and consulting with a qualified bariatric surgeon, you can make an informed decision that aligns with your unique needs and goals. Remember, the journey to a healthier you, begins with taking the first step and seeking the right guidance.

Examining the Pros and Cons of Bariatric Surgery

Experience a Journey Towards a Healthier You!

Weight loss surgery, also known as bariatric surgery, can be a transformative step towards a healthier and happier you. This procedure acts as a powerful ally in your weight loss journey, helping you achieve significant, lasting weight loss. As a result, the risk of developing serious health conditions like heart disease, diabetes, and even some cancers can be significantly reduced. Bariatric surgery allows you to unlock a future filled with increased energy, improved mobility, and a renewed sense of well-being.

Moreover, here’s the good news: weight loss surgery has become much safer over time. Thanks to newer techniques, better training for surgeons, and quality control programs, the mortality risk associated with this surgery has gone way down, from around 1.5% to a much lower 0.3%. So, while it remains a major procedure, it can be a powerful tool to help people with obesity live longer, healthier lives.

Consider the Option that Best Meets Your Requirements

There are different procedures available for Bariatric surgery, and surgeons can choose the best option based on each patient’s, individual needs.

Roux-en-Y Gastric Bypass: This two-pronged surgical approach tackles weight loss by both curbing appetite and reducing nutrient absorption. Staples are used to create a smaller stomach to limit the amount of food intake, and certain section of the small intestine is bypassed to limit the nutrients and calories absorbed.

Sleeve Gastrectomy: The method encompasses the stapling and removal of a portion of the stomach to reduce the size of the stomach to that of a small banana. It also influences weight loss by altering gut hormones that regulate appetite, taste, and blood sugar levels, contributing to feelings of fullness after consuming a smaller volume of food.?

Mini Gastric Bypass: In this surgery, the surgeon creates a long, sleeve-shaped pouch from the stomach. This pouch is then connected directly to the small intestine, forming a loop.

Banded Gastric Bypass: By adding a band to a gastric bypass surgery, surgeons can precisely control the pouch and stoma sizes in this banded gastric bypass procedure. This standardization and adjustability can potentially improve weight loss outcomes in the long run.

Single-anastomosis duodeno-ileal bypass with sleeve gastrectomy (SADI-S) is a two-part weight loss surgery. The first part involves reducing the stomach’s size through a procedure called sleeve gastrectomy. The second part reroutes the digestive system. This reduces the body’s ability to absorb fats and calories, leading to weight loss.

Is Weight Loss Surgery Right for Me?

Weight loss surgery isn’t for everyone. The question comes round to:

Am I qualifying for bariatric surgery?

Bariatric surgery is for patients with:

BMI > 32.5 kg/m2 with obesity related co-morbidities

BMI > 37.5 kg/m2 without co-morbidities

BMI > 30 kg/m2 with life-threatening obesity-related disorders like uncontrolled diabetes, cardiovascular disease/cardiomyopathy, and severe obstructive sleep apnoea

Bariatric Surgery to be considered only between the ages of 18 – 65 years

Bariatric surgery may be considered in patients more than 65 years in the presence of severe obesity-related co-morbidities/disability

Bariatric Surgery may be considered in patients < 18 years in special situations after paediatrician/endocrinology certification, or after attainment of puberty or completion of skeletal maturity

Obesity treatment encompasses a lot more than stated. A good lifestyle works wonders with a follow-up routine. Moreover, regularly consulting the multidisciplinary team to monitor progress is fundamental to addressing the underlying potential complications.

Weighing the Pros and Cons of Bariatric Surgery

Weight-loss surgery is an effective and more reliable alternative to lose 60-80% of your excess weight within a year of surgery. Significant weight loss after bariatric surgery positively impacts cardiac metabolism, workload, performance, and structure.?

Bariatric Surgery improved the quality of life for 95% of patients with an 89% reduction in 5-year mortality.

Migraines 57% resolved

Depression 55% resolved

Pseudotumor cerebri 96% resolved

Obstructive sleep apnea 74-98% resolved

Dyslipidemia hypercholesterolemia 63% resolved

Asthma 82% improved or resolved

Cardiovascular disease 82% risk reduction

Hypertension 52-92% resolved

Non-alcoholic fatty liver disease 90% improved steatosis; 37% resolution of inflammation; 20% resolution of fibrosis

GERD 72-98% resolved

Metabolic syndrome 80% resolved

Type II diabetes mellitus 83% resolved

Stress urinary incontinence 44-88% resolved

Polycystic ovarian syndrome 79% resolution of hirsuitism; 100% resolution of menstrual dysfunction

Degenerative joint disease 41-76% resolved

Venous stasis disease 95% resolved

Understanding the risks associated is of equal importance. By and large, every surgery involves risks.

Risks of Bariatric & Metabolic Surgery

The more extensive the bypass operation, the greater the risk for complications and nutritional deficiencies. Patients with extensive bypasses of the normal digestive process require not only close monitoring but also may require the use of special foods and medications. Five to ten percent of patients who undergo weight-loss operations may require surgical/medical interventions to correct complications.

Rare complications of gastric bypass surgery include leak through staples or sutures, ulcers in the stomach or small intestine, and blood clots in the lungs or legs (it is hence important for all our patients to strictly adhere to the compression stockings and LMWH therapy as advised postoperatively), stretching of the pouch or oesophagus, persistent vomiting, and abdominal pain, inflammation of the gallbladder, and failure to lose weight.

Many a patient undergoing bariatric surgery develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. A person’s risk of developing gallstones increases during rapid or substantial weight loss.

A few studies have reported up to 30 percent of patients who have weight-loss surgery may develop nutritional deficiencies such as anaemia, osteoporosis, and metabolic bone disease. These deficiencies can be avoided if vitamin and mineral intakes are maintained – a close follow-up with our dietician is thus emphasized.

Women of childbearing age should avoid pregnancy for 12-15 months until their weight becomes stable because rapid weight loss and nutritional deficiencies can harm a developing fetus. Though some bariatric procedures can be reversed, patients should carefully consider all of the risks and benefits before electing to have this surgery.

Patients with uncontrolled diabetes, retinopathy, neuropathy, and nephropathy are advised a very close monitoring of their blood sugar and other medications with regular follow-up. Patients who have been advised C-PAP/Bi-PAP must strictly adhere to the usage, or else it could even prove fatal.

In short bariatric/metabolic surgery is not a magic pill but could work like magic if used and practised judiciously under supervision.

Post-Surgery Care and Management

Post-bariatric surgery, there are a few things to keep in mind to make it a success. Here’s what your post-bariatric surgery care must involve.

Your surgeon and healthcare team will be there to watch over you, answer questions, and help avoid any problems. They’ll also track your weight loss to see how you’re doing.

Having good people around you is important. Friends, family, or even a support group can be a big help after surgery. They can offer encouragement and understand what you’re going through.

Food after surgery is a step-by-step process. Right after, for 15 days it’ll be non-aerated, sugar-free liquids like fat-free milk, buttermilk, soy milk, almond milk, strained soups, coconut water, etc. It’s like giving your stomach a little rest for a few weeks to heal up. Then, things will slowly move to soft foods for the next 15 days that are easy to chew and digest. Make sure to get plenty of protein during this time, like lean meats or dairy products. After a month the diet becomes normal, focusing on protein-based foods.

Don’t forget to move your body! So, getting some exercise is a great way to manage the long-term effects of bariatric surgery, feel better overall, and keep the extra kgs away for good.

Your Weight Shouldn’t Be the Barrier to the New ‘You’!

Bariatric surgery, or weight loss surgery isn’t just about the numbers on the scale. It can be a major win for your overall well-being!

Studies show that people who have weight loss surgery not only manage health problems better but also feel a lot better about themselves. They have more energy, and they feel more confident in their own skin.

Of course, everyone’s reasons for wanting weight loss surgery are different. The important thing is to talk to your surgeon about all your options and concerns. They can help you decide if weight loss surgery is right for you and provide support before and after surgery.

References:

https://asmbs.org/patients/is-metabolic-and-bariatric-surgery-right-for-you/

Bariatric (Weight Loss) Surgery: Types & Requirements (clevelandclinic.org)

Medanta | Beyond Weight Loss: Understanding Bariatric Surgery and Its Life-changing Benefits

Bariatric surgery – Mayo Clinic

Bariatric Surgery: What You Need To Know – Forbes Health

Best Weight Loss Surgery in Delhi NCR, Weight Loss Treatment in india (atulpeters.com)

risks-and-complications-of-bariatric-surgery.ashx (clevelandclinic.org)

Effect of exercise training before and after bariatric surgery: A systematic review and meta?analysis – PMC (nih.gov)

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6538485/

https://www.niddk.nih.gov/health-information/digestive-diseases/dumping-syndrome

https://www.ncbi.nlm.nih.gov/books/NBK594253/

How Mini Gastric Bypass Surgery Can Transform Your Health and Lifestyle

Mini Gastric Bypass Surgery: A Comprehensive Guide to Weight Loss and Health Benefits

Bariatric surgery has become increasingly popular due to its proven effectiveness in achieving long-term weight loss and resolving weight-related health problems compared to non-surgical methods.

Mini Gastric Bypass Surgery, also known as One-Anastomosis Gastric Bypass Surgery (OAGB), is a type of bariatric surgery that is minimally invasive and involves creating a smaller stomach pouch (restriction) to limit food intake and rerouting part of the small intestine (malabsorption) to reduce nutrient absorption. The result is both decreased food intake and less calorie absorption, promoting significant weight loss.

What is a Mini Gastric Bypass?

Mini Gastric Bypass surgery is performed under general anaesthesia. It typically involves three to four small incisions. In this technique, a long gastric tube is created, resembling a sleeve and a wide loop anastomosis requiring only one anastomosis (surgical joint). The length of the intestines bypassed varies between 170 cm and 250 cm, depending on the individual needs of each patient.

The mini gastric bypass is classified as a malabsorptive procedure, resulting in reduced absorption of ingested food.

Health Benefits of Mini Gastric Bypass

Mini Gastric Bypass surgery offers significant weight loss and health improvements for people struggling with obesity. Here’s how it benefits you:

Effective Weight Loss: Patients can expect to lose 60 to 70% excess weight with an initial rapid reduction of 8 to 10 kilograms per month for the first few months and then at a comparatively slower rate. You tend to achieve your target weight in 1-1.5 years post-surgery. Long-term success is dependent on regular follow-up with your surgeon and bariatric dietician and maintaining a healthy diet and exercise routine.

Reduced Hunger and Increased Fullness: The surgery brings about positive hormonal changes leading to promoting a feeling of fullness with smaller portions, helping you manage hunger and calorie intake.

Improved Blood Sugar Control and Diabetes Management: Mini Gastric Bypass can significantly improve blood sugar control and even lead to remission of type 2 diabetes.

Reduced Risk of Obesity-Related Conditions: The surgery can help address other health problems associated with obesity, such as high blood pressure and sleep apnea.

Potential Reversibility: Unlike some weight loss surgeries, Mini Gastric Bypass is potentially reversible due to its simpler design.

It’s important to remember that Mini Gastric Bypass requires a lifelong commitment to healthy habits. This includes following dietary recommendations, taking regular vitamin and mineral supplements, and attending follow-up appointments with your surgeon.

Lifestyle Changes and Improvements

After Mini Gastric Bypass surgery, expect a hospital stay of about 1 to 2 days. Your surgeon will prescribe pain-relieving medications to manage discomfort. You will be given instructions to follow regarding wound care, diet, and activity such as:

Keep the incision area clean and dry
Avoid strenuous exercises and lifting heavy weights
Sip liquids throughout the day as suggested by the dietician to stay hydrated
Follow an exercise program as per your surgeon’s instructions to maintain the weight loss
Take nutritional supplements as advised

How this surgery improves and enhances your overall quality of life:

Facilitates an active lifestyle – As you lose weight, you’ll likely have more energy for physical activities. Regular exercise (aerobic, strength training, and flexibility) is critical to maintaining weight loss and overall health.
- Helps you manage underlying Associated Medical Issues – Weight loss may improve one’s overall well-being and help manage health conditions such as inflammation, diabetes, arthritis, and other conditions associated with obesity. Your surgeon will monitor your progress, based on which some medications might be eliminated as the health improves eventually.
- Improves Fertility – One possible result of weight loss surgery is improved fertility. If you plan to get pregnant, discuss it with your surgeon. They might recommend a waiting time of 18 months post-surgery.

Eligibility and Considerations

Mini Gastric Bypass surgery may be an option for patients struggling with obesity, but BMI (Body Mass Index) plays a key role in determining eligibility.

Bariatric surgery is for patients with:

BMI > 32.5 kg/m2 with obesity-related co-morbidities
BMI > 37.5 kg/m2 without co-morbidities

BMI > 30 kg/m2 with life-threatening obesity-related disorders like uncontrolled diabetes, cardiovascular disease/cardiomyopathy and severe obstructive sleep apnoea
Bariatric Surgery to be considered only between the ages of 18 – 65 years
Bariatric surgery may be considered in patients more than 65 years in the presence of severe obesity-related co-morbidities/disability
Bariatric Surgery may be considered in patients < 18 years in special situations after paediatrician/endocrinology certification, or after attainment of puberty or completion of skeletal maturity

Consulting with a qualified and experienced bariatric surgeon is essential to determine if the Mini Gastric Bypass Surgery is the right alternative for you. They will consider individual circumstances, including BMI, health history, and overall health goals.

Selecting the Best Surgeon and Facility

Your choice of clinic and surgical team plays a crucial role in the success of your Mini Gastric Bypass surgery. Here’s why top bariatric surgery centres can make all the difference:

Expertise at Every Step: A renowned bariatric surgeon runs a comprehensive bariatric program. They’ll guide you through pre-operative evaluation, ensure you have access to state-of-the-art surgical facilities, and provide extensive support post-surgery.

A Team You Can Trust: To run a comprehensive bariatric program, it is essential that the team comprises a Bariatric Surgeon, Bariatric Nurse, Bariatric Dietician, Program Managers and Coordinators.

Before deciding, take some time to research renowned bariatric surgeons. Here are some key factors to consider:

Accreditation: Look out for clinics and surgeons accredited by recognized healthcare organizations, ensuring they meet the highest safety standards.

Surgeon Qualifications: Research the surgeon’s experience and qualifications in performing Mini Gastric Bypass surgery.

Success Rates: Inquire about the surgeon’s success rates for the procedure.
Patient Testimonials: Reading real patient experiences can offer valuable insights into the surgeon’s approach and patient care.

Inspiring Success Stories

Ms Kamaljeet, a housewife from Delhi met Dr. Peters with Co-morbidities like Diabetes Mellitus, Hypertension, and a BMI of 46.4 which were making life difficult for her. Post Surgery in 6 months she lost 30 kgs and HbA1C came down to 5.5 from 7.0 and now she leads a normal and happy life free of any medications.

Mr Manish young businessman from Gorakhpur met Dr. Peters with complaints of morbid obesity (BMI: 48.2 kg/m2), backache, joint pains, and breathlessness. After many unsuccessful attempts to lose weight through gym and diet, he decided to undergo bariatric surgery. In a period of six months, he lost about 32 Kg and is maintaining the same through regular follow-up and adhering to a suggested diet pattern.

They are both free from their previous medical issues and are enjoying a vibrant and joyful life. They express deep gratitude to the my entire team for transforming their lives and enabling them to live with renewed energy and positivity.

Embracing a Healthier Future

Mini Gastric Bypass surgery is a game-changer in weight loss surgery. It’s a minimally invasive procedure with big benefits for your health and life. By learning about its advantages, the surgery itself, and what to expect afterwards, you can make a well-informed choice about getting it done at a leading clinic. With proper preparation, support, and following post-surgery instructions, you can achieve significant weight loss and experience a dramatic improvement in your overall well-being.

References