This is the oldest intervention once performed by wide scars and emphasized by laparoscopy*.
The Gastric By-Pass is certainly the most effective intervention resulting in the most rapid, important and probably the most sustainable weight loss.
It is the most difficult intervention, technically spoken, with a risk of complications in short and long-term. The most important complications occur even in the simplified version of Mini By-Pass.
The absence of food absorption at the level of the proximal part of the intestine causes deficiency of several essential vitamins, obliging lifelong therapy of vitamin replacement and some deficiencies can be very difficult to treat in the long-term.
- Aftercare is very important, abdominal pain is difficult to label and not exceptional.
- Gives the best result at the level of near-constant weight loss and significantly improves diabetes type II or fat.
- The most mutilating and dangerous operation with regard to operating risk: postoperative complications because of the length and difficulty : fistula **, occlusions ***, bleeding, abscesses…
- Risk of deficiencies due to the absence of absorption that require mandatory and regular nutritional monitoring.
- An operation which is not easily reversible.
INDICATION: BMI ≥ 45, failure of former bariatric surgery (gastric band or sleeve gastrectomy), nibbler, compulsive eater, diabetic.
* Laparoscopy = watch inside the belly; everyone knows now about this technique invented by French that is to insert a camera and instruments by small scars of 1 cm or less.
** Fistula = term used when 2 segments of intestine closed together by staples, suture threads, glue… do not want to heal (like a wound that wouldn’t close), the contents of the intestine or stomach then empties into the stomach and causes life-threatening abscesses and peritonitis.
*** Occlusion = obstacle to the flow of contents of the digestive tract that can be caused by adhesions due to the operation.
© Dr. Jean-Pierre Anfroy | Last update 02/11/16