Gastric bypass surgery is considered the gold standard among surgical interventions for weight loss and glycemic control. During the consultation process, your bariatric surgeon will explain to you the different types of gastric bypass procedures available. Based on your BMI, co-morbidities, and personal goals, they will recommend the right type of gastric bypass surgery for you.
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Types of gastric bypass procedures
Two major types of gastric bypass procedures are performed today: Roux-en-Y gastric bypass and biliopancreatic diversion gastric bypass. Both types of bariatric bypass surgery involve rerouting (bypassing) of the small intestine, in addition to stomach reduction. The primary difference is the length or extent of intestinal bypass that is created in both these surgeries to achieve maximum weight loss and relief from type 2 diabetes.
Roux-en-Y Gastric Bypass
Among all types of gastric bypass, Roux-en-y technique is the most popular and delivers most predictable results. Roux-en-y gastric bypass has been around for more than six decades, and since the 1990’s a less invasive laparoscopic approach has been perfected to perform this surgery.
Let’s look at how the Roux-en-y types of gastric bypass procedures work.
- Stomach reduction: Following general anesthesia and incision placement, your surgeon will divide the stomach into two parts. The top portion will be about 20 to 25% of the original stomach volume, which will be stapled for form a small gastric pouch. The larger portion will be surgically removed. This step will reduce the stomach’s food storage capacity.
- Intestinal bypass: The second step in these types of gastric bypass Roux-en-y involves a division of the small intestine. The lower end of the small intestine (at about 3.5 ft. downstream) is connected directly to the newly created pouch. This creates a new Y-shaped gastrointestinal route bypassing a significant part of the small intestine.
- How it works: The new small pouch will help reduce your meal portions and make you feel full faster. The intestinal modification will reduce the absorption of calories and lower the hunger hormone production. These types of gastric bypass Roux-en-y will also induce metabolic changes to reduce or resolve your type 2 diabetes symptoms through glycemic control.
Biliopancreatic Diversion Gastric Bypass
Patients with super obesity (BMI of 50 or above) may benefit the most from one of the more advanced types of bariatric bypass surgery called the biliopancreatic diversion (BPD) gastric bypass. This procedure is usually performed with a duodenal switch technique. Your surgeon may recommend these types of gastric bypass procedures if you have high diabetes and severe obesity.
- Pouch creation: The first step in this procedure is similar to the standard types of gastric bypass Roux-en-y surgeries. Once you have been placed under anesthesia, your surgeon will create small abdominal incisions. They will remove a substantial part of the stomach tissue and leave behind a small banana-shaped pouch.
- Intestinal rerouting: This is the most important step in these types of gastric bypass procedures. The duodenum (initial portion of the small intestine) will be connected to the far end of the intestine. This technique is called duodenum switch, which will leave out (bypass) a large middle section of the intestine, creating a biliopancreatic diversion for food.
- How it works: The more extreme rerouting of the small intestine in these types of bariatric bypass surgery is designed to create a profound malabsorptive effect. Because a large part of the intestine has been bypassed, the calorie absorption will be drastically reduced. You can achieve a massive weight loss in a short time period.
CHECK THIS: Gastric bypass vs duodenal switch
How to choose the right type of gastric bypass surgery
Your bariatric surgeon will help you make a careful choice among the different types of gastric bypass procedures. In most cases, the laparoscopic technique is used to perform this surgery. However, in rare cases, the surgeon may recommend a traditional open surgery technique. Make sure you work with a surgeon who has adequate experience in performing all types of gastric bypass.
Determining candidacy for the right type of surgery
- If your BMI is between 35 and 40 with co-morbidities, you may be a candidate for a Roux-en-y gastric bypass (RYGB).
- If your BMI ranges from 40 to 50 with or without co-morbidities, your surgeon may recommend an RYGB surgery.
- If your BMI exceeds 50 with or without co-morbidities, you may benefit the most from a biliopancreatic diversion gastric bypass.
- If your BMI is between 45 and 50 with severe or insulin-dependent type 2 diabetes, you may choose a BD gastric bypass.
- Make sure to share your full medical history to help your surgeon determine the best types of bariatric bypass surgery for you.
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Pros and cons of different types of gastric bypass
- Between the two major types of gastric bypass, Roux-en-y is relatively less invasive with a lower risk of complications.
- Biliopancreatic diversion gastric bypass can produce more rapid and effective weight loss in patients with super obesity.
- Duration of the surgery in the operating room as well as anesthesia time will be relatively longer in case of a BD gastric bypass.
- Remission or resolution of type 2 diabetes is possible in both types of gastric bypass procedures, but BD has a higher success rate.
- Nutritional deficiency risks are present in both types of gastric bypass, but RYGB has a relatively lower risk than BD.
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Types of gastric bypass surgery at Jet Medical Tourism®
At Jet Medical Tourism®, our experienced team of bariatric surgeons is well-versed in all types of bariatric bypass surgery. We work with state of the art hospitals and bariatric centers that are fully equipped to support the latest and most advanced types of gastric bypass surgeries. We encourage you to have a free virtual consultation with one of our top-rated bariatric surgeons to determine your best treatment options. Call our friendly and compassionate patient coordinators today.