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RNY GASTRIC BYPASS

General features

  • It is a combined restrictive and malabsorbtive procedure.
  • Until now, it is the most performed "golden standard" obesity surgery procedure and still very popular in the USA and many european countries.

RNY Gastrik Bypass Operasyonu

IMPACT MECHANISM

  • The patient, whose stomach has been reduced in size by performing a RNY Gastric Bypass, consumes smaller portions of food and feels much faster satisfied.
  • The RNY Gastric Bypass operation is also a malabsorptive procedure and limits the total calorie intake.
  • Postoperatively, the level of ghrelin hormone decreases (appetite hormone).

The fast and voliminous consumption of calorie-rich food (especially food containing carbohydrates and fats) can cause nausea. To prevent this, the patients adapt to eat healthier and changes their eating/drinking habits

RNY Gastrik Bypass operasyonu

1. The first image shows the oesophagus, the stomach, and the beginning of the small intestine.

2. In the RNY Gastric Bypass operation, the stomach is separated with a staple into a small piece and a large piece, so that the patient can eat smaller portions (restrictive effect).

3.The small intestine is divided (A) and and ready to be connected with the reduced stomach.

4.The small intestine (A) is pulled up from where it is divided and connected to the gastric pouch with a circular stapler.

There is no entry of food in the remnant stomach but this remnant stomach will still produce juices and necessary enzymes needed for digestion and absorption of nutrients. At point B on this figure, the remnant stomac and the continuing small bowel end of this remnant stomach is reconnected to the main route of the nutrients. Thus, the enzymes and juices (B) produced by the remnant stomach enter the main circuit at a more distal point.

RNY GASTRIC BYPASS ANIMATION



Based on scientific research, weight loss in our patients occurs as follows.

*  AT 6 WEEKS: From the initial weight            -%10
*  AT 3 MONTHS: From the initial weight            -%15
*  AT 6 MONTHS: From the initial weight           -%20
*  AT 9 MONTHS: From the initial weight           -%25
*  AT 12 MONTHS: From the initial weight        -%30 - 35
These numbers may vary depending on the eating, drinking and exercising habits of the patient.


RISKS AND COMPLICATIONS:


Short term Long term
Leakage Anastomotic ulcer
Bleeding Gallstones
Respiratory Infection Incisional hernia
Embolism Intestinal Obstruction
Intestinal Obstruction  
Wound infection  


Advantages of RNY Gastric Bypass

Disadvantages of RNY Gastric Bypass

  • Reversible procedure
  • Technically challenging for the surgeon.
  • Comfortable eating pattern
  • Higher rates of stomach ulcers, especially in the smokers-group
  • Reflux dissapears very often
  • Dumping syndrome
  • Provides a more permanent solution for type 2 diabetes and other comorbidities (compared with sleeve gastrectomy)
 
  • Lower weight regain rates compared with sleeve gastrectomy
 
  • No "only-iquid-period" postoperatively
 

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