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A mini-gastric bypass is one type of gastric bypass or stomach bypass. These procedures belong to the group of surgeries known as bariatric surgery, the purpose of which is to make changes to the digestive system, in order to help people lose weight.
Bariatric surgery including the mini-gastric bypass, is still considered ‘new’ surgery. The first full gastric bypass operation was performed in 1954 and since that time the procedure has undergone several changes. The mini-gastric bypass was first developed in 1997 by an American doctor – Dr Robert Rutledge.
The full gastric bypass procedure has existed longer than mini-gastric bypass surgery, so some surgeons are still not trained to use the mini bypass procedure and will always suggest the full gastric bypass surgery as their chosen method of treatment. However, the mini gastric bypass procedure has become increasingly popular over the last few years, with more and more evidence pointing to its effectiveness and benefits over the established full bypass surgery. It is a relatively simple procedure which usually takes about 60-90 minutes and requires only about one day in the hospital.
Usually, the surgery is performed laparoscopically. This means that small incisions are made in the abdomen and the operation is performed using a laparoscope – a rod with a tiny video camera and light at the end of it. As with all weight loss surgeries, it does physically alter the shape and size of the stomach so the decision to have the surgery should be carefully considered, although the mini gastric bypass is one of the bariatric procedures which can be reversed.
So exactly what is a mini gastric bypass?
During the procedure, the surgeon creates a ‘mini’ stomach – a long narrow tube. The remainder of the stomach, although still functional will no longer receive or process food. The small intestine is attached to this new mini stomach to create the ‘bypass’. This is usually all performed using staples and stitches. It also means a large part of the small intestine – anything from 3 to 7 feet – will also be bypassed All of this is usually done with a laparoscope so the patient will only have up to 5 small incision marks in their abdomen.
This mini-gastric bypass will help the patient to lose weight in two different ways. Firstly, the stomach size is considerably reduced so much smaller portions of food must be eaten and secondly, the reduction in the intestine means less food is absorbed by the body.
As with all stomach bypass surgery, weight loss results are not 100% guaranteed, however, generally, patients tend to reduce their weight after surgery quite significantly.
There is also growing evidence to show that the mini-gastric bypass is a safe and effective alternative to other bariatric surgical operations.
As mentioned earlier, the mini gastric bypass procedure changes the digestive system quite dramatically and, although reversible, it is designed to be permanent. Most public health services (e.g. the British National Health Service and the US National Institutes of Health), as well as private health organisations (e.g. the Mayo Clinic), have strict guidelines when it comes to who is eligible for a stomach bypass.
Reputable surgeons will adhere strictly to these guidelines.
There are a few different types of surgery for a gastric bypass. The full gastric bypass is most often performed using the roux-en-y procedure. The mini gastric bypass is essentially a version of the full gastric bypass. Both types of surgery are designed to reduce the size of the stomach and thus help with weight loss.
Like the full gastric bypass, or indeed many of the bariatric procedures, there is some preparation required prior to the procedure.
The patient will be expected to have already followed an eating plan in order to reduce the size and stiffness of the liver. This is also good practice for the necessary eating plan after the surgery. For more details on these eating plans – see our article on gastric bypass.
So, what are the main differences when we consider mini gastric bypass vs gastric bypass?
In the gastric bypass vs mini gastric bypass debate, more and more research is indicating that overall the mini gastric bypass is at least as good as the full gastric bypass and in many cases even better.
So, what of the results from the mini gastric bypass procedure? Firstly, it is important to understand that this procedure is not a magic bullet, but with good eating habits and an exercise plan the results can be very good indeed.
The surgeon/clinic will advise on the specific diet for each patient after a mini gastric bypass. Immediately after the operation there will be a ‘liquids only’ diet with more solid food gradually introduced over an eight-week period. Thereafter, the patient will be on a ‘permanent diet’, as the size of the stomach is now markedly reduced.
Those patients who stick to the guidelines can expect to lose approximately 60-75% of their excess weight over a two year period, with all the attendant health benefits that this weight loss brings with it. Maximum weight loss occurs between 12-24 months after the procedure and, sometimes, the patient will gain a little weight after this ‘peak’ of weight loss has been reached. However, over a ten year period most patients will maintain a loss of about 70% of their excess weight.
Some of the other health benefits attributed to gastric bypass procedures and recorded in research are:
First and foremost it is important to state that mini gastric bypass complications occur rarely and their frequency is often lower than for a full gastric bypass.
Marginal ulcers may occur in up to 3% of patients. The main symptom is a feeling of burning in the stomach. Usually they can be fairly easily treated with antacids.
Gastrointestinal bleeding may also occur in up to 3% of patients. There are a number of ways to resolve this problem, and the surgeon will select the best solution.
Wound infection can occur in any operation where the skin is cut. Operations performed laparoscopically have lower occurrence rates because the skin punctures are so small. If the wound is well cared for, antibiotics will usually help it to heal.
About 1% of patients may suffer a gastrointestinal leak – this is when the newly created ‘connections’ start to leak digestive content into the abdomen. If these leaks are detected early they can be relatively easy to fix; for those detected after some time, corrective surgery may have to take place.
Bile reflux, although more common in mini gastric bypass than gastric bypass, still affects less than 1% of patients. This is when bile backs up into the stomach and oesophagus causing heartburn, nausea and vomiting. There are various solutions but, in severe cases, a reversal operation may be required.
As with any type of surgery there is also a small risk of blood clots in the legs or lungs. Measures are always taken to attempt to prevent these occurring.
The major mini gastric bypass side effects are concerned with the fact that the digestion system has been changed. It is important to remember that in addition to reducing the size of the stomach, the absorption of the food eaten has also been reduced. This may lead to a lack of essential substances such as albumin in the blood and iron and other vitamins and minerals. It is absolutely essential that vitamin and mineral supplements are taken on a regular basis after any type of gastric bypass. In addition, our body takes much of its daily hydration from the food we eat, so when food intake is reduced it is necessary to increase liquid intake. A minimum of two litres of water a day is recommended after gastric bypass surgery. Occasionally, patients may also develop an intolerance to food, beverages and drugs which were previously OK for them.
More serious side effects include gallstones (up to 30% of patients), which are often associated with rapid weight loss. Some surgeons may, in fact, remove the gall bladder as part of the mini gastric bypass surgery, as, like the appendix, it is not actually required. Kidney stones may also occur, often because the patient has not been drinking enough fluids. Some patients have complained of initial hair loss, although it subsequently does grow back. This is almost certainly connected with a lack of certain vitamins and nutrients and/or the body’s response to the trauma of surgery and dramatic weight loss.
Although, in some cases, there may be some quite serious mini gastric bypass problems, the medical profession recognise that often the benefits of the surgery e.g. less cardiovascular risk, longer expected lifespan, the disappearance of type 2 diabetes among many others, far outweigh the relatively small incidences of risks and complications.
A mini gastric bypass operation UK will mean paying for a private operation. In theory full gastric bypass operations are available on the NHS to those patients meeting all the requirements, but funding pressures and other needs which are classified as more pressing, mean that it is very difficult to obtain this treatment.
Once a UK patient has weighed up all the mini gastric bypass pros and cons and decided to have this particular procedure, then the only realistic route is probably private surgery.
The mini gastric bypass cost in the UK will vary from hospital to hospital and within the different regions. Many private surgeons in the UK offer a gastric bypass but not so many offer the mini gastric bypass. So, firstly it may mean travelling some distance to find a hospital/clinic that will provide this procedure. Generally the costs are slightly lower than for a gastric bypass so can range from about £9,500 to £14,000. Normally, the patient will need to be monitored for some time after the operation, with regular appointments both with the surgeon and the dietitian. It is important, therefore, to check if these ‘additional’ appointments are included in the initial cost. Other costs may include travelling to/from the clinic/hospital and taking days off work for the initial procedure and subsequent appointments.
Due mainly to the cost in the UK, many people consider having a procedure like a mini gastric bypass abroad. As with any medical procedure, it pays to do some homework when selecting a hospital/clinic and surgeon in a different country. Medical tourism booking sites, like Clinic Hunter, should always be able to provide in depth information about the institution and surgeon.
The big advantage of having the procedure abroad, is, of course, the huge cost savings which can be made. In addition, because these hospitals/clinics have a steady flow of medical tourists wanting the same procedure, many of the surgeons are consistently performing the same surgery and have become experts in that specific area.
On the downside, it will probably mean a flight to the country in question, which may be uncomfortable for an obese person, and may be even more uncomfortable on the way home after an operation. The patient can either return to the hospital/clinic for the aftercare service or can purchase an aftercare package in their home country. In the unlikely event that additional surgery is required for some reason e.g. bile reflux, it may be difficult to arrange this in the home country.
Poland ticks many of the boxes when it comes to considering a mini gastric bypass abroad. In the last twenty years or so, it has been positioning itself as one of the countries of choice for a variety of different medical and dental procedures. Hospitals and clinics are modern and well-appointed with state of the art equipment. Surgeons and medical staff are all well-trained and are obliged to keep themselves up-to-date with the latest medical innovations and opinions. English is widely spoken in the cities, so communication should not be a problem.
Flight times from the UK to Poland are around 2½ hours and there are frequent budget airline flights from many main and provincial airports in the UK to several airports in Poland including the major medical centres of Warsaw, Krakow, Gdansk and Wroclaw among others. The cost of an air ticket may be as low as £20 depending on the season and when the flight is booked in relation to the departure date.
The price of a mini gastric bypass in Poland is around 50% of the UK cost. Depending on the surgeon and venue most procedures cost between £5000-£6000. Doctors will usually prepare a special quotation for each patient.
Turkey is another country, which specialises in medical tourism for a variety of different procedures. It now has many specialist medical venues especially for foreign medical tourists.
Like Poland, medical staff are generally well-trained, although, as with all foreign doctors and venues, it is advisable to double check their credentials with an agency like Clinic Hunter. Clinics are clean and modern with up-to-date equipment. Surgeons tend to be specialists in the particular procedure that they offer.
Flight times from the UK to Turkey are longer than to Poland at around 4 hours. The cost of flights is reasonable especially to the holiday destination airports in Turkey like Bodrum, Dalaman and Antalya. The added bonus of having the procedure done in one of these destinations is that additional days after the surgery can be spent relaxing on the beach.
A mini gastric bypass in Turkey costs from around £4000 although, as in Poland, doctors will prepare a special quotation for each individual patient.
As with all bariatric surgery the decision to have a mini gastric bypass should not be taken lightly. Even after the surgery some degree of willpower is required to maintain a healthy eating pattern. Although it is a fairly new procedure all current research points to the fact that it is at least as good as a gastric bypass with comparable weight loss results and less complications. It is also, if required, reversible. Not all surgeons are trained to use this new method, so finding a surgeon near to home may be a problem. This type of surgery is not available on the NHS in the UK (only the full gastric bypass), so the only option is to have the procedure carried out privately. Somewhere in the region of 50% of the cost can be saved by having treatment abroad.
Bile reflux: https://www.heighpubs.org/hjsr/ascr-aid1028.php
Mini gastric bypass vs gastric bypass: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1357700/
Diabetes and gastric bypass: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1514677/
Cardiovascular disease and gastric bypass: https://pubmed.ncbi.nlm.nih.gov/18805125/
High blood pressure and gastric bypass: https://pubmed.ncbi.nlm.nih.gov/23077152/
Migraines and gastric bypass: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1421184/
Non-alcoholic fatty liver disease and gastric bypass: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1402345/
Polycystic ovarian syndrome and gastric bypass: https://pubmed.ncbi.nlm.nih.gov/22169760/
In the UK Anne was a professionally qualified trainer with many years of experience in the training industry. She mainly worked in the travel, tourism and leisure industries (including Thomas Cook and British Airways) as well as in other sectors.
Since moving to Poland twelve years ago, Anne has become involved in other business sectors – teaching English as a foreign language and translating documents from Polish into English. She specialises particularly, in medical translations and works closely with dentists, cardiologists and neurologists in translating and preparing articles for publication. She has also trained as a practitioner in the field of neuro-linguistic programming and is a qualified hypnotherapist.
Any spare time is spent renovating the house in Poland which Anne bought some years ago.
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