THE MINI BYPASS OR “GASTRIC BYPASS OF ANASTOMOSIS” (GBA)

The “mini bypass” or “GBA” is a weight loss and metabolism control surgery, whose principal differences between a Roux-En- Y Gastric Bypass Surgery will be outlined as follows:

  1. Only one connection between the stomach and the intestine is made without making another from intestine-intestine (Roux-En- Y), which, in turn, is a quicker surgery in terms of operating time.
  2. The intestine that is bridged in order to do the bypass is longer in a Roux-En- Y bypass, because of which the area of malabsorption is greater, which gives us a greater weight loss, as such we can say that the “mini bypass” is a principally malabsorption surgery.
  3. A larger stomach mass is left compared to its counterpart in the Roux-En- Y surgery because the stomach or large reservoir allows the patient to ingest a larger quantity of food and allows for control, in the majority of cases, of bile reflux; this means that the bile returns to the esophagus now that the bile will now always stop at the stomach-intestine connection. To avoid the bile reflux, maneuvers are made, such as the large reservoir and certain modifications to the intestinal handle so that the bile continues on course without generating reflux.
  4. The method is by laparoscopy and the surgery takes, on average, 40-50 minutes of operating time.
  5. Not making the intestine-intestine connection yields lower adherence and intestinal obstruction possibilities compared to the Roux-En- Y bypass.
  6. Patients with severe obesity are used given that malabsorption is important and yields a greater weight loss.

 

However, it is also important to mention that the “mini” term does not mean “less,” rather it describes a surgery that generates greater malabsorption, so taking vitamins is considered for life after the procedure, which we will also number the potential contingencies that can arise and why a multidisciplinary team with a Chief Surgeon that has experience in the different techniques is fundamental in order to avoid complications, because, unfortunately, an increase in the rate of execution of this procedure by inexperienced teams is seen, since it is technically a “simpler” procedure to do.

  1. The possibility of bile reflux, because of which a patient with previous reflux should not have a mini bypass done.
  2. The necessity of lifetime vitamin supplements after the surgery.
  3. In the case that a leak is presented, the treatment would be a conversion of the bypass to that of the Roux-En- Y surgery, or reverse the procedure entirely (rather, the use of invasive surgery compared to a Roux-En- Y procedure, which can be handled by endoscopy and medication).

In conclusion, it is an excellent option, but your choice should be an informed one and individualized for each patient, and all details of such should be explained.

It is also important to mention that it is a new surgery in terms of studies, being accepted by the IFSO just this year. Because of this, there is little about the long-term results, being one of the biggest studies in Asia and Middle East. However, it is worth mentioning that the results are encouraging, always and whenever a patient counts on a multidisciplinary team, like MtyBariatrics, in order to lead a highly satisfactory
recovery and change.

For more information about the Mini Bypass (GBA), contact us and we will kindly clarify any doubts you may have.

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