Gastric Bypass / Laparoscopic Omega loop gastric bypass
Procedure:
The stomach is divided and a small longitudinal gastric pouch is created. Then a loop of the small intestine is attached to the pouch in order to bypass the remnant stomach and the first 200cm of small bowel. As with the Y-en-Roux gastric bypass this procedure limits the amount of food intake in addition to a reduced absorption capability of nutrients and calories. Moreover a later expansion of the pouch can be overcome by implantation of a non-adjustable banding (banded bypass).
Hospital stay: 2-3 days
Excessive weight loss: 60-80% in 2 years
Advantages of Omega loop gastric bypass:
After undergoing an omega loop bypass surgery a more rapid and sustained weight loss occurs when compared to other surgical techniques such as laparoscopic-adjustable gastric banding or sleeve gastrectomy. In addition it is a less complex intervention than the Y-en-Roux gastric bypass surgery, can be performed in a shorter period of time and fewer early complications.
This technique combines a restriction of food intake with a reduction of the functional absorptive intestinal length, leading to a malabsorption. Furthermore it is also applicable in patients with a sweet eating or binge eating behavior. In contrast to laparoscopic-adjustable gastric banding no drastic change of diet is required.
Disadvantages of Omega loop gastric bypass:
Life-long intake of vitamins and minerals are necessary as well as subcutaneous vitamin B12 injections every 6 months. A conventional upper gastroscopy of duodenum, remnant stomach and biliary tract is not possible after the surgery. Side effects can include dumping syndrome, vertigo and temporary discomfort. Repetitive dietary mistakes lead to a reduced weight loss. In less than 1% of patients symptomatic biliary reflux might occur. In these cases a switch to Y-en Roux Gastric Bypass has to be performed.