Roux-N-Y Gastric By-Pass
Roux-N-Y gastric bypass (RNYGP) is currently the most common type of obesity surgery in the world, especially in the US. UU. The surgical indication for gastric bypass is the same as for all other obesity operations. This procedure is preferably carried out in the so-called sweet dining room, that is, in small patients but very high in calories. Because only reducing stomach volume does not lead to adequate weight gain, a procedure that restricts absorption should be added. Unlike the tube, there will be an intervention in the small intestine, which is not applicable to patients with chronic intestinal disease. How to apply the Roux-N-Y gastric bypass.
How does Roux-N-Y gastric bypass work, how does diabetes improve?
Gastric bypass has a reducing effect on both gastric volume and absorption. Approximately 50 cc stomach bag reaches tension with a small amount of food and feels like satiety. In addition, since the first portion of the small intestine is closed to the passage of food, the energy of food is limited. In addition to these two effects, preventing contact with food from the first part of the small intestine, such as gastric bypass and duodenal change, causes some hormonal changes. The small intestine is the body's most secretory hormone organ, with the exception of food absorption. These hormones are called integrins. The YY and GLP-1 peptide appear to be two of the most important hormones in metabolism. The intake of GLP-1 increases after food intake skips the first part of the small intestine and arrives early to the advanced parts. The higher level of GLP-1 breaks down insulin resistance in tissues and leads to a rapid recovery of diabetes. The hormonal effect is explained by the fact that the sugar levels of diabetic patients reach normal levels in the early postoperative period before they begin to lose weight. GLP-1 is the active ingredient in some sugar medications, but the hormone taken by mouth is not as effective as the usual reaction in the body. Insulin resistance decreases with weight loss and decreased fat in tissues. Approximately 100 units of insulin hormone do the work of 10 units of insulin. In addition, the hormone called resistin increases to high levels and increases insulin resistance in tissues in patients with more abdominal fat. The decrease in intra-abdominal fat and the decrease in resistin levels are another hormonal effect that breaks down insulin resistance.
Advantages and disadvantages of Roux-N-Y gastric bypass surgery;
The main advantage of gastric bypass surgery is that it is a 60-year operation and its long-term results are well known. It not only reduces the volume of the stomach, but also creates a relatively low absorption disorder and provides rapid weight loss. In patients with morbidly obese diabetes, the tube provides a faster recovery than gastric surgery. On the other hand, as the normal route of the digestive system changes, vitamin and mineral deficiencies are more common than gastric tube surgery. Technically it is more difficult to review in case of weight gain again and should be performed by highly experienced teams. One of the most important differences in gastric bypass surgery from gastric tube surgery is the removal of the dissected stomach in the sleeve gastrectomy and its retention in the gastric bypass. This means that there is a stomach that cannot be seen after gastric bypass surgery.
What are the risks of Roux-N-Y gastric bypass surgery?
In addition to the common risks in all obesity surgeries, there are certain process specific risks. Stenosis, anastomosis leakage and vitamin / mineral deficiency are the most prominent risks in the gastric pouch and the region of attachment to the intestine (anastamosis). In addition, a condition called Dumping syndrome, which can be seen in all gastric surgeries with the pylorus canceled, can be seen after Roux-N-Y gastric bypass surgery. more or less; Since the natural covering at the exit of the stomach is avoided, the uncontrolled passage of food to the small intestine causes the liquid to pass into the small intestine and causes sweating, falling blood pressure and fainting. These complaints, which usually occur after carbohydrate intake, are resolved by diet. The risk of death due to the procedure is around 0.4%. The risk of gaining weight again after surgery is 15-16%. With the latest technological advances in the medical world, these surgeries are performed very safely in experienced centers.
Period after Roux-N-Y gastric bypass surgery
Fluid foods start the next day and the patient is discharged on average in 3-4 days. Within a week, the person returns to normal life. The expected weight loss at the end of a year and a half is 65-70% of excess weight.