Different Weight Loss Surgery Options
Around the world there is an even spilt of preference between the gastric bypass and the sleeve gastrectomy. In the past the most common way of performing gastric bypass surgery was with two joins on the inside, to bypass the stomach called a laparoscopic Roux-en-Y gastric bypass (LRYGB). Over the last decade performing a one-anastomosis gastric bypass surgery, also known at the Mini Gastric Bypass (OAGB) has been gaining in popularity and is now being rapidly adopted in the UK and NHS Practice.
What is a Mini Gastric Bypass?
The mini gastric bypass is a relatively new operation, first performed in 1997. It involves stapling the stomach starting from its lower part (known as the antrum) to create a long thin gastric pouch, similar to a sleeve gastrectomy. However, unlike sleeve gastrectomy where the rest of the stomach is removed, in this operation the stomach remains in place but food bypasses most of the stomach and the first metre and a half of small bowel.
The number of Mini Gastric Bypass surgeries performed worldwide is increasing steadily. This operation has been proven to be technically more simple and just as safe and effective as the Roux-en-Y gastric bypass and takes around 40-60 minutes.
What is the aim of the Mini Gastric Bypass?
With a Mini Gastric Bypass, you can expect to lose around 1/3 of your total body weight. Unlike weight loss from dietary changes alone, weight loss after this surgery is maintained for the long term.
It will finally be possible for you to lose weight without feeling physically hungry.
What does the Mini Gastric Bypass Involve?
- It is usually performed laparoscopically, through keyhole surgery under general anaesthetic.
- You will be admitted on the day of surgery and can expect to go home a day or two after surgery.
- The operation works mainly through altering gut signals helping you feel less hungry as these hormones control appetite, taste and blood sugars.
- It reduces the size of the stomach. This replumbing means that food passes directly into the small bowel.
- Bypass and sleeve surgeries remove the majority of the hunger hormone (grehlin) in the year after surgery as the food does not come into contact with the part of the stomach that produces the majority of the hormone signal. This means you can follow a normal healthy diet in a year after surgery.
- Once you get to a year after surgery, the body naturally starts to produce more hunger hormone from elsewhere in the bowel and your weight stabilises.
- During this first year you will have established new eating habits to become a new you.
What are the risks?
The specific risks of the mini gastric bypass can include:
- Bile reflux
- Ulcers
- There is around a 1 in 100 risk of bleeding or damage to the stomach or bowel which can require a reoperation, a change to open surgery with a bigger incision and a slow recovery.
- The risk of death is rare if you as an individual, are fit enough to survive a reoperation as an emergency.
In the long term the three most common complications are:
- An ulcer at the join between the stomach and bowel,
- Malnutrition,
- Acid or bile reflux.
The risk of ulcers can be reduced by acid-reducing medications.
Along with a balanced dietary intake, you will need to take lifelong iron, vitamin D, calcium, vitamin B12, folate and multivitamin supplements to reduce any risk of problems with deficiencies.
If acid or bile reflux affects your quality of life, there is a longer-term risk of needing to reoperate to change the Mini Gastric Bypass to a Roux-en-Y bypass, to treat the reflux.
With any type of weight loss surgery approximately 5% or 1 in 20 patients may need consideration for further surgery in their lifetime to assess or treat any possible complications of surgery.
What can I do to achieve the best outcome with the Mini Gastric Bypass?
- Choose a surgical service that includes:
- Expert Consultant Bariatric Surgeons who also work within the NHS
- Specialist Dieitians
- Expert Clinical Psychologists
- Access to a Specialist Pharmacist
- Access to a Consultant Endocrinologist
- Make sure you meet with members of the bariatric surgery team, before surgery to discuss which weight loss treatments are suitable for you
- At Verve Health Group you will meet your surgeon at the very start of your journey to allow you time to understand your options and have all your questions answered.
- You will then meet with a dietitian who will help you to understand what it is like to live with a Mini Gastric Bypass as well as the dietary changes needed.
- You will also meet with a clinical psychologist who will give you tips and tricks to ease your adjustment after surgery, to give you the best possible chance of achieving your goals, and to reduce the risk of weight regain in the future.
- Within the first year after surgery, ensure you are making time to develop new habits and learn how your body responds to different food.
- Work with your bariatric surgery team after your Mini Gastric Bypass. Research has found that people who engage with their clinical team, have the best outcomes.
- At Verve Health Group we offer in-person and virtual clinic appointments to suit you. We also have different aftercare package options.
- Like any other bariatric treatment, you will need to undergo lifelong, annual follow-up with either your GP team or surgical team. This is normally a simple check that your dietary intake is balanced, your weight is stable and blood tests show no vitamin or mineral deficiency.
- At Verve Health Group, we can arrange specialist blood tests from your home, along with a review appointment with a specialist dietitian to talk you through your blood test results, and to help you with any nutritional support you may need. You can also meet with a clinical psychologist to help you to refocus if you find your weight has begun to change.
We know that you have battled with your weight all your life, so we want you to have the best possible outcome with your Mini Gastric Bypass. We will do our very best to help you achieve this.
What are the reasons I couldn’t have the Mini Gastric Bypass?
If you have complications from reflux disease such as Barrett’s disease, or if you have a hiatus hernia you may be more suitable for a Roux-en-Y gastric bypass instead.
We always consider the risks and benefits of every treatment option for our patients but for you as an individual, different choices may mean more risks or benefits.
Speaking to a specialist Bariatric Surgeon is therefore essential, to help you to choose the right operation.
What do I do now?
Find out more about our specialist team. You can book an appointment with one of our Consultant Bariatric Surgeons. If you need to arrange a different time to meet a surgeon, you can book a time slot to speak to a member of the office team, or complete our contact form and one of the team will get back to you.
You can have a Mini Gastric Bypass in Bristol at the Spire and Nuffield Hospitals and in Newport at St Joseph's Hospital.
We look forward to working with you to start the next chapter of your life.
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