BODY MASS INDEX
Mini Gastric Bypass
Mini gastric bypass (MGB) which is a modification and implementation of loop gastric bypass is technically easier than a RYGB and it is performed laparoscopically. MGB is a simple and safe method and it is increasingly accepted worldwide.
MGB is the division of the last part of the stomach from the the smaller curve in the body. The stomach is further divided into the angle of His (the angle between the esophagus and stomach that prevents reflux). Afterwards, the piece of stomach is made anastomosis after the intestine which is approximately 200 cm away. The remaining stomach keeps closed in the stomach just like in RNY Gastric Bypass.
Mini gastric bypass combines both limiting and absorption-reducing properties for weight loss. There are possible hormonal changes that regulate sensitivity and reduce hunger. The connection between the gastrointestinal bladder and the small intestine is related to excretory physiology and may cause unpleasant symptoms such as feeling faint, nausea, sweating and / or diarrhea added to stomachache when high sugar meal is taken. This case is called “Dumping Syndrome”. This result is described as a negative situation against the consumption of a high sugar diet after surgery.
The optimal length of the digestive arm is a controversial issue in achieving the best balance between weight loss and malabsorption complications, Lengthening the length of the digestive arm can cause an increased malabsorption because lengthening the digestive arm shortens the middle arm where the main digestion and absorption of nutrients take place. Today, most surgeons do not extend the digestive arm more than 150 cm.
Ghrelin is a hormone hidden in the forestomach (stomach and duodena) that triggers the early phase of meal consumption. It is seen that the normal regular release of this appetite producing hormone is restrained in patients with stomach bypass. The restraint of this ghrelin has also been observed in laparoscopic sleeve gastrectomy (sleeve gastrectomy) surgery. The low ghrelin level may contribute to the characteristic loss of appetite which seen in patients with RYGB. In general, hormones such as Glucagon-like peptide-1 (GLP-1) and cholecystokinin which increase after by-passes have been proven to support the anorexia.
The high rate of gall reflux cases and the fact that this situation is more pronounced in patients with defects in the valve between the gullet and stomach is a situation that ruins the comfort of life. Patients with this situation may have vomiting attacks and the bypass may need to be revised to RNY Gastric Bypass. In addition, it can be observed that the connection between the stomach and intestine expands and the person can eat more comfortably. This situation is parallel with the disappearance of the restrictive feature of the surgery. Weight gain is possibly observed in this surgical method as well.