Mini Gastric Bypass

What is The Mini Gastric Bypass Surgery?

Mini Gastric Bypass Surgery, also known by One Anastomosis Gastric Bypass or by MGB, is a common Bariatric Surgery. Mini Gastric Bypass, like other Bariatric Surgeries, aims to trigger weight loss through modifications to the digestive system that restrict the absorption of the nutrients. The stomach is made into a small tube, and the effective bowels are shortened.

After Mini Gastric Bypass Surgery, consumed food will go through the new tube shaped stomach and then go into the newly attached part of the small intestine, bypassing 6.6 to 8 feet (200 - 250 cm) of the small intestine.

Mini Gastric Bypass is done Laporoscipally, which shortens the recovery period and prevents permanent surgery scars.

Mini Gastric Bypass is named after the Roux En Y Gastric Bypass, but has only a single anastomosis instead and combines properties of the Gastric Sleeve and Gastric Bypass. Mini Gastric Bypass is frequently preferred over Gastric Bypass due to its successful results and being the shorter, as well as, cheaper method.

 

Why is Mini Gastric Bypass Surgery Performed?

Mini Gastric Bypass is used as a primary weight loss procedure, and used to treat obesity and obesity-related medical conditions. Mini Gastric Bypass is also the preferred revisional surgery for patients who were unsuccessful with Gastric Band or Gastric Sleeve.

Mini Gastric Bypass alleviates gastroesophageal reflux, heart diseases, high blood pressure, high cholesterol, sleep apnea, and type 2 diabetes, but is not the suitable option for patients who have acid reflux as Mini Gastric Bypass will exacerbate it.

Surgical methods, like Mini Gastric Bypass, are often recommended if the patient is morbidly obese to such a degree that even dieting and exercises are not enough to help the patient lose weight.

Mini Gastric Bypass, like Gastric Sleeve, is performed laparoscopically, i.e. using small keyholes instead of opening up the abdomen.

What are The Conditions Of Mini Gastric Bypass Surgery?

The final decision on if a patient qualifies for Mini Gastric Bypass or if Mini Gastric Bypass is recommended is made by our Bariatric Team, here are some of the qualifying criteria that our Bariatric Team uses for Mini Gastric Bypass:

  • A Body Mass Index, BMI, of at least 35 is required, or having an obesity related condition with a BMI of 30.
  • Must not have tested positive for Covid within the month before surgery.
  • Must not have an active infection at the time of the surgery.
  • Must not have Acid Reflux caused by a hiatal hernia.
  • Chronic diseases, such as type 2 diabetes, hypertension disease etc, might require additional testing before arriving in Turkey.
  • Patients should stop smoking and alcohol at least 6 months before surgery.

What Are The Things To Be Considered Before Mini Gastric Bypass?

After a patient qualifies for the Mini Gastric Bypass, their Patient Coordinator, along with a treatment schedule, will provide the patient with a Liver Fat Reducing Diet that should be followed before arriving at the hospital. The patient should not consume any food or liquid 12 hours before the surgery in order to make sure the stomach is empty before surgery. The following dietary and medicinal restrictions have to be followed before the surgery as well:

  • Usage of vitamin K should be stopped 30 days before surgery as it is an anticoagulant, i.e. blood thinner, and increases the rate of complications associated with internal bleeding.
  • Oral contraceptives and any other contraceptives that have estrogen or progesterone, like coils, HRT patches, or birth control implants, must be stopped or taken off 30 days before the surgery as they increase the rate of complications arising from blood clots. Hormonal and oral contraceptives can be used 30 days after surgery. Non-hormonal implants are safe and recommended if considering a mini gastric bypass.
  • Smoking should be avoided starting a week before surgery until three weeks after surgery. Smoking causes the veins to constrict and limits blood circulation, potentially causing complications such as leakage.
  • Alcohol consumption should preferably be avoided in the last 3 months leading up to the surgery. Alcohol consumption a week before surgery should especially be avoided as it will increase the burden on the liver and might cause complications with anesthesia.
  • The patient will have a consultation with an internal diseases specialist, radiologist, anesthesiologist, and a general surgeon before the surgery.
  • Preoperative tests at the hospital will include full abdominal ultrasound, chest x-ray, breath functioning test, electrocardiogram, endoscopic investigation of the stomach, and full blood test as pre operation test and exams.

 

What Are The Things To Be Considered During Mini Gastric Bypass?

The surgery takes about 60 to 90 minutes to complete. Like the Gastric Bypass, the Mini Gastric Bypass surgery is also a two - part procedure that separates approximately 25% of the stomach from the rest of the stomach. A pouch is created from the smaller part of the stomach, and is then joined to the small intestine with an anastomosis. After surgery, the majority of the stomach and approximately 6.6 - 8 feet (200 to 250 cm) of the small intestine are bypassed which means they are no longer involved in the digestion or absorption of the food eaten.

The surgery is performed under general anesthesia. The surgeon makes 4 - 6 keyhole cuts on certain points of the patient's abdomen. A camera and surgical instruments are inserted through these keyholes. The camera is connected to a video monitor in the surgery room that allows the surgeon to view the inside of the abdomen for the operation.

The stomach is divided with a laparoscopic stapler and a smaller tube shaped stomach is formed. Remainder of the stomach is no longer attached to the esophagus and will no longer help with the digestion of the food. The surgeon will then bypass 6.6 to 8 feet of the intestines and the remainder is then attached to the new stomach. As a result, the food that passes from the small stomach into the small intestines is met with the digestive juices that have been produced in the remaining bigger stomach.

What Are The Things To Be Considered After Mini Gastric Bypass?

Mini Gastric Bypass postoperative prescriptions given to the patients will include blood thinner injections and stomach protectors. The medicine provided will include antibiotics and painkillers that should be used if needed. A Booking Surgery dietician will provide a diet list for each patient and will provide additional support if needed. The initial dietary restrictions post surgery will be as follows:

  • The patients will only consume liquids for the first 3 weeks following surgery. Also called the liquid stage, patients are advised to consume protein shakes, soups, herbal tea, etc.
  • The patients are advised to consume puree and liquid foods for the following 3 weeks. Also called the puree stage, patients are recommended to increase their diet by eating mash and blended foods.
  • After 6 weeks of liquid and puree stage, the patients can start consuming solid foods. After Mini Gastric Bypass surgery, patients should never eat solid and liquid foods at the same time.
  • Additionally, patients should avoid caffeinated or carbonated drinks for 3 months following surgery, but decaffeinated coffee can be safely consumed 10 days after surgery.
  • Patients should also avoid smoking, alcohol, and any recreational drugs for at least 3 weeks following surgery.

Post surgery, some physical activities should be avoided as well:

  • Patients can go back to work 2 weeks after getting home if it's not a physically strenuous job.
  • Patients should avoid strenuous activity and sexual intercourse for the first month following surgery.
  • Patients should walk frequently and should not do any heavy lifting more than 5 KG for the first month following surgery and not more than 10 KG for the first 3 months after surgery.
  • Patients can start exercising to help the weight loss process 2 months after the surgery.

Additionally, the surgical stitches will dissolve on their own, but if they do not, patients should take an appointment from their GP to get them removed.

 

What are the Risks of Mini Gastric Bypass Surgery?

Mini Gastric Bypass Surgery, while being shorter than Gastric Bypass and being done Laporoscipally, has some risks associated with it like any major surgery. These risk include:

  • Increased risk of acid reflux
  • Increased risk of bile reflux
  • Bleeding
  • Infections
  • Intestinal Obstruction
  • Leakage
  • General anesthesia complications
  • Blood clots
  • Deep vein thrombosis

Blood thinners and compression socks provided after surgery lower the likelihood of blood clots and deep vein thrombosis.

These risks most likely show up within the first month after surgery.

What are the Long-Term Complications of Mini Gastric Bypass?

The long-term complications of Mini Gastric Bypass Surgery can be explained as follows:

  • Stomach Ulcers
  • Incisional Hernia
  • Malnutrition
  • Gallstones
  • Dumping Syndrome

Malnutrition:

Malnutrition occurs when the body is deprived of vitamins, minerals and other nutrients needed to maintain healthy tissue and organ function.

The long term side effects of Gastric Bypass (Roux en Y) Surgery, as a result of malnutrition, include:

  • Vomiting
  • Pain
  • Fatigue
  • Dry Skin
  • Mood Changes
  • Hair Loss
  • Hernias
  • Gastroesophageal reflux
  • Hypoglycemia

Gallstones:

During the rapid weight loss after Gastric Bypass surgery, approximately the first 6 months, gallstone formation increases by up to 20%.

Dumping syndrome:

Dumping syndrome is caused by the food and liquids in the stomach reaching the small intestine in a short time after Mini Gastric Bypass Surgery.

What To Do When Weight Loss Surgery Doesn't Work?

If Mini Gastric Bypass surgery is performed correctly by a certified surgeon, the patient will lose a significant portion of their excess body weight. In some cases, patients might experience severe acid reflux after mini gastric bypass which might require a revision into a Roux En Y Gastric Bypass. A revision from mini gastric bypass to roux en y gastric bypass might be considered.

The surgery is considered a failure if the patient regains the weight in a few years. Going back to old eating habits by forcibly overeating or frequently drinking carbonated drinks may cause the stomach to enlarge, therefore allowing weight regain.

Poor weight loss often leads to consideration of a revision surgery. In such a case, a revision from Mini Gastric Bypass to Gastric Bypass might be performed.

What Are the Advantages Of Mini Gastric Bypass?

Mini Gastric Bypass has many advantages which can be listed as follows:

  • It is performed in a modified manner that involves less intestinal rerouting and a shorter overall procedure time.
  • Risk of internal hernia is lower than due to Roux en Y Gastric Bypass.
  • Mini Gastric Bypass is reversible as parts of the old stomach are not removed from the abdomen.
  • Alleviates obesity-related health problems such as type 2 diabetes, hypertension, sleep apnea, and acid reflux.
  • Within the first year after the surgery, patients lose 75% of their excess body weight, and 80% - 90% of their excess body weight within the first two years.
  • Less likely to gain back excess weight, unlike yo-yo dieting, the weight loss is usually for life.
  • Produces positive changes in intestinal hormones that reduce appetite and increase the feeling of fullness.
  • Decrease in excess weight alleviates the pressure on the knees and joints, increasing the recovery rate of osteoarthritis up to 85%.
  • It is performed in a modified manner that involves less intestinal rerouting and a shorter overall procedure time.

What Are the Disadvantages of Mini Gastric Bypass?

While Mini Gastric Bypass Surgery has many advantages, it does possess some disadvantages that have to be considered before going through with the surgery. Some of the disadvantages include:

  • Compared to other stomach reduction operations, the possibility of complications is higher since the operation involves a wider portion of the digestive system.
  • Although it is rare, as Mini Gastric Bypass reduces absorption, vitamin deficiency may occur.
  • Bariatric vitamin supplements have to be taken permanently after the operation.
  • Endoscopy becomes harder to perform on the patient after the Mini Gastric Bypass surgery, but is still possible.
  • There are chances of bile reflux gastritis. This is considering that mini-gastric bypass surgery does not divert the bile and digestive enzymes from the stomach. Therefore, there are chances of a condition that can be hard to treat.
  • Even though the Mini Gastric Bypass Surgery is less invasive, it still carries potential infection risks. Leakage or infection among staples connecting the stomach and intestines is also possible.
  • There is a possibility of complications similar to Roux-en-Y gastric surgery. The most common being surgical site hernias, ulcers, and other minor infections.
  • Has short and long term risks associated with it.

 

Which is better: gastric bypass or mini bypass?

Both Gastric Bypass and Mini Gastric Bypass surgeries are performed laparoscopically. Two anastomoses are made during Gastric Bypass and a single anastomosis is made during Mini Gastric Bypass. Mini Gastric Bypass is the shorter surgery, but provides a similar weight loss. But, while Gastric Bypass completely treats Acid Reflux, MIni Gastric Bypass often exacerbates it. Neither can be considered better, but offer a trade off between complexity and additional side effects.

How much weight can you lose with a mini gastric bypass?

The patients, on average, lose 80% of their excess body weight within a year, their weight loss slows down afterward and stabilizes near their target weight.

The rate and amount of weight loss vary greatly from person to person, and according to lifestyle choices and eating habits of the patient as well as their gender and age.

How big is your stomach after a mini bypass?

In mini gastric bypass surgery, a gastric tube is first created, similar to sleeve gastrectomy surgery, but smaller in size. Then, the first 150-200 cm of the small intestine is disabled and the small intestine is connected to the lower end of the newly formed tube stomach.

How long does it take the stomach to heal after a mini gastric bypass?

Patients who undergo Mini Gastric Bypass surgery usually stay in the hospital for 4 more days.

While it is not possible to eat solid foods immediately after the operation, liquid nutrients are safe to consume. Patients should not lift heavy weights after the surgery for at least a month and can return to work 10 days after going back home.
 

Who is a candidate for a mini gastric bypass?

Mini Gastric Bypass surgery is a common Bariatric Surgery and is performed to patients who have Body Mass Index, BMI, of at least 30. Obesity related illnesses, such as high cholesterol or high blood pressure, should also be a motivation to have a Mini Gastric Bypass. Mini Gastric Bypass is also a good option for patients who have previously had a Gastric Band or a Sleeve Gastrectomy but have failed to lose weight.

Can you put weight back on after a mini bypass?

As with other bariatric surgery methods, there is no guarantee that weight loss will be permanent after Mini Gastric Bypass Surgery. Having an active lifestyle, and keeping a healthy diet will make weight regain less likely.

Can you drink alcohol after a mini gastric bypass?

It is not recommended to consume any alcohol for the first 6 months following the Mini Gastric Bypass surgery. Additionally, alcohol is high in calories and low in nutrition, therefore is not recommended for anyone trying to lose weight.

What is Body Mass Index (BMI)?

Body mass index (BMI) or height-weight index is a calculation method that shows the estimated fat content of a person's body. This method is based on the person's height to weight ratio. According to the result of the index, the proximity and distance of the person's current weight to his/her ideal weight can be calculated

How is Body Mass Index Calculated?

Body mass index is calculated by dividing the body weight by the square of the height (kg/m⊃2;).

Results below 18.5 kg/m⊃2;: Below ideal weight

Results between 18.5 kg/m⊃2; and 24.9 kg/m⊃2;: Ideal weight

Results between 25 kg/m⊃2; and 29, 9 kg/m⊃2;: Above ideal weight

Results between 30 kg/m⊃2; and 39, 9 kg/m⊃2;: Above ideal weight (obese)

Results above 40 kg/m⊃2;: Above ideal weight (morbidly obese)

 

What Do Body Mass Index Results Mean?

Body mass index calculation does not include factors such as fat ratio, body type, fat and muscle tissue. For this reason, experts obtain more detailed information about the person's weight problem by measuring the metabolic rate and detailed body analysis, in addition to measuring the body mass index and waist circumference in calculating the ideal weight. The fact that the person is above or below the ideal weight should be evaluated by the physician together with other factors. Action should be taken together with the physician to eliminate existing health problems and prevent possible health problems.

In men, if the waist circumference exceeds 94 cm, it is considered an increased risk, and if it exceeds 102 cm, it is considered high risk. In women, this ratio is considered increased risk if it exceeds 80 cm and high risk if it exceeds 88 cm.

Obesity Calculation with Detailed Body Mass Index

In calculating obesity with detailed body mass index, it can be learned whether the weight, body fat percentage and waist circumference are within normal values, taking into account age and gender.

First of all, it is very important for the diagnosis and treatment of obesity to know where the fat tissue accumulates in the body. The way fat tissue accumulates in the body can be divided into two as apple type and pear type.

In apple type obesity, fat accumulates around the belly. In pear type obesity, it is observed to accumulate in the hips and thighs. However, the fat accumulated around the navel is considered to be more dangerous and has a higher risk of heart disease than the fat accumulated in the hips and thighs.

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What an amazing experience. Like most, the idea of travelling to another country for a medical procedure was nerve wracking at first however, my amazing care co ordinator Sean was there every step of the way! I arrived on the 31st December and everything from my booking experience, hospital stay, pre op tests, gastric sleeve surgery , transport home and post op assistance has exceeded alp expectations. I am from the UK and all of the care far surpassed anything that I have recieved in the UK. Sean has also been there post me returning to the UK to check in and respond quickly to any post op questions that I have had. Would 100% reccomend

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Had a bit of a mix up but this was easily fixed and my feedback taken onboard for future patients 😊 The hospital is immaculate with very friendly and caring staff. I was very well looked after before and after surgery. After surgery nurses would check on me every 1.5/2 hours and if I rang the bell they would come instantly. Translators were brilliant and the staff who didn’t speak much English was very good with google translate 😊 The care and the cleanliness at the hospital I went to Medistanbul was out of the world. Puts the UK hospitals to shame honestly! Had so many family & friends telling me don’t go abroad for surgery but it’s the best thing I ever done! My coordinator Rick Miller was so quick at responding, always kept me up to date and was very helpful throughout the whole process. My surgeon was Prof Dr Kagan Katar who was very professional, he came to see me before and after operation Also the transfer driver Orhan was amazing he was so helpful with our bags in the huge airport and sorted us out with wheelchairs Had a brilliant experience

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I had arm lift surgery with Dr Ahmet on 8 October 2024. David Turker was my co ordinator. From the collection at the airport to dropping be off ;I also had dental implant and my partner has a hair transplant) everything went smoothly. They’re organised and efficient. There are several interpreters and staff who work for Booking Surgery who are resident at different times in the ward of the hospitals. On 30/1/24 I returned to finish off my tooth implant and to have a deep plane facelift, a neck lift and upper eyelid blepharoplasty. Again everyone was fantastic. My only critique is the hospitals’ food, which, similar to UK is not great but I knew that prior to going and found out where the nearest shops were. I also ordered in pizza via the helpers and they got me stuff from the shop. They also got me a soft pillow as the pillow on my hospital bed the second time was like a boulder with wee pebbles in it LOL. But this is a minor thing and plenty of cheap pillows for sale nearby. I felt that my treatment in Istanbul was better than any I’d ever received in the UK and I’ve had over 5 operations in Scotland. The nurses in Turkey are so kind and compassionate. Any medication you need for any ancillary issues that arise is readily prescribed to you. The surgeons are lovely too and experienced and professional. I had Dr Emre Koçman for my face etc., ab older guy in his 60s with great experience. I’m not 10 days post op and pleased Ruth progress. I’m 65 and once healed I'm going to look 45. That wasn’t my aim but I’ll take it LOL ! Thank you booking surgery. You’re the best. Maxine

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