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.

Side Effects of Bariatric Surgery

Understanding the Side Effects of Bariatric Surgery: What You Need to Know

Overview of Bariatric Surgery

Bariatric surgery is increasingly being accepted as a viable option for treating morbid obesity and its associated diseases such as diabetes mellitus and hypertension. Surgery provides long-term sustained weight loss as well as resolution of co-morbid conditions.

The benefits of bariatric surgery are numerous but there are also a few risks and side effects associated with various bariatric surgical procedures.

Common Bariatric Procedures in India

The most common bariatric surgical procedures performed in India are:

laparoscopic sleeve gastrectomy,

laparoscopic roux-en-y gastric bypass, and

laparoscopic mini gastric bypass.

Immediate Side Effects of Bariatric Surgery

There are a few immediate side effects that can happen after bariatric surgery like bleeding, leak, intestinal obstruction, and venous thromboembolism. The side effects due to malnutrition or undernutrition are seen in the long term, particularly after laparoscopic gastric bypass surgery.

The incidence of bleeding is less than 4% in patients undergoing bariatric surgery. Most cases can be managed by blood transfusions alone. Some cases might require laparoscopy to stop the bleeding. A leak from the anastomosis site or sleeve staple line occurs in about 0.7% to 5% of the patients. If the leak is early, re-laparoscopy with identification of the leak and its closure is done with adequate drainage, bowel rest, and antibiotics.

Similarly leaks after a mini gastric bypass can be managed early by drainage and conversion of the procedure to Roux-en-Y gastric bypass along with a feeding tube in the intestines. The other rare immediate problem can be that of wound infection which is managed by dressing and antibiotics. Obesity is an independent risk factor for thromboembolism which is the clotting of blood in the veins of the body particularly the legs. This is best avoided by taking heparin injections for the first few days after the surgery and wearing graded pressure stockings for a few weeks. Early active mobilization is the best precautionary method.

Long-Term Side Effects and Nutritional Deficiencies

Lately, there can be obstruction of the intestines due to various factors which result in pain and distension of the abdomen along with vomiting. The possible causes usually are smoking, and the formation of ulcers. This can be identified by doing an endoscopy or a CT scan. Treatment of the possible causes can be done immediately.

After bariatric surgery, iron, vitamin B12, and other micronutrient deficiencies can occur. Iron deficiency occurs in patients within 2 to 5 years after surgery. Supplementation with iron can reduce iron deficiency significantly. Calcium and vitamin D absorption are impaired after gastric bypass as well. We obtain a complete blood count and iron, B12, calcium, folic acid, vitamin D, levels before surgery, 6 months and 1 year after surgery, and yearly thereafter. We recommend routine daily supplementation with a multivitamin, iron, vitamin B12, and calcium along with vitamin D supplementation depending on the serum levels.

Dumping Syndrome

Dumping syndrome is a common side effect after Roux-en-Y Gastric Bypass (RNYGB) surgery. This usually occurs due to poor food choices. It is related to the ingestion of refined sugars (including high fructose corn syrup) or high glycemic carbohydrates. It can also occur with dairy products, some fats, and fried foods.

The fact is that these foods will interfere with long-term weight loss and should not be eaten anyway.

Symptoms start typically 20-30 min after the food. It includes sweating, flushing, lightheadedness, tachycardia, palpitations, desire to lie down, upper abdominal fullness, nausea, diarrhea, cramping, and active audible bowel sounds.

Conclusion

In summary, although bothersome and sometimes worrisome, dumping syndrome is not a life-threatening problem. Patients need to learn about and read basic nutrition labels. The benefit is that it teaches patients quickly that certain foods and additives cannot be tolerated. Patient compliance and commitment to long-term follow-up are mandatory.

In short, the side effects of bariatric surgery are rare. Timely
identification and intervention are the keys to preventing serious complications.

Still confused about bariatric surgery? Then schedule your consultation with the top bariatric surgeon in Delhi at Smart Cliniqs.

Bariatric Surgery Hospital in Delhi

Choosing the Best Bariatric Surgery Hospital in Delhi for Effective Weight Loss

Delhi is the popular destination for medical tourism. Patients from every corner of the world come to Delhi, India for bariatric surgery. Many hospitals in Delhi are currently performing the surgery. Bariatric surgery hospitals in Delhi are specialized centers with trained and expert surgeons and specialized paramedic staff. In Delhi, both private and government hospitals are performing bariatric surgery. To name a few, private hospitals like Indraprastha Apollo hospitals, Max Healthcare, BLK super specialty, Fortis, Medanta hospital are performing bariatric surgery in Delhi. Premier government hospitals like All India Institute of Medical Sciences (AIIMS), Ram Manohar Lohia (RML), Lok Nayak Hospital (LNJP) are also performing bariatric surgeries.

Roux-en-y- gastric bypass surgery is the “gold standard” procedure. It refers to a type of bariatric surgical procedure in which the stomach is divided into a small pouch and then the small intestine is rearranged and connected to the newly created pouch. Roux-en-y- gastric bypass surgery is used to promote weight loss and also improve weight related issues like type 2 diabetes, hypertension, high cholesterol, arthritis, sleep apnea, infertility, hypothyroid, joint pain, backache etc.

Obese patients have a compromised vitamin and mineral intake due to excess energy consumption. Drastic weight loss post roux-en-y-gastric bypass surgery compounds the already present vitamin and mineral deficiencies. Patients who undergo Roux-en-y-gastric bypass surgery should attend regular follow-up sessions with a registered dietician so that deficiencies could be identified and treated at an early stage.