When gastric bypass the stomach is separated a few inches below the stomach entrance.
t leaves a small remaining stomach, "pouch", which holds about 15 ml and serves as a brake for the food supplied, the small intestine is also severed, one
end of the intestine is connected to the small remaining stomach and the other redirected so that the Food and digestive juices are first mixed in the middle small intestine and the upper,
directly to the stomach adjoining small intestine is bypassed. The digestive juices are introduced in the deeper intestinal sections and thus can only begin digestion by the decomposition of the
food components. The result is that not all food components can be decomposed and thus only a part taken up "resorbed". There are thus fewer nutrient components available to the blood. The
undigested food is transported to the colon.
The disadvantages of the gastric bypass
The physiology in the digestive process is changed. Not only the intake of calorie carriers is reduced, but also the vitamins, minerals and trace elements.
In particular, vitamin B 12 can no longer be "absorbed" by the normal digestive power and the dose must be given by injection for life. In some cases this also applies to the absorption of iron.
The permanent intake of a multivitamin preparation is required daily. Certain medications should no longer be taken orally because they may damage the intestinal mucosa. Others are degraded in
their effectiveness, e.g. Hormones.
Depending on the food composition, side effects such as bloating, foul-smelling fatty stools, diarrhea and the so-called "dumping syndrome" with circulatory
decline and lightning-like evacuation may occur after eating very sugary foods and drinks.
The restrictive effect of the little "pouch" can be lost over time and then normal-sized to large amounts of food can be eaten
again.
It is no longer possible to perform an endoscopic gastroscopy or to remove bile duct stones.
Laparoscopic surgery
This is done by keyhole technology, i.e. laparoscopically or minimally invasively, over five small
Holes ranging in size from 1.5 to 2.5 cm. The abdomen is first filled with a gas so that the surgeon has a better view of the abdominal interior. Now the
surgeons solve the problem in a the stomach of adhesions, for example to the spleen, in order to subsequently make the actual
reduction.
An important sub-step of the operation is the so-called leak test:
at the end of the procedure, the doctor fills the new stomach with a blue liquid for a short time via a small gastric tube to ensure that the sutures are
absolutely tight.
Thus, the rate of complications in the hands of experienced surgeons is very low.
