ROUX-EN-Y Gastric Bypass

ROUX-EN-Y Gastric Bypass

The goal of obesity treatment is to safely reduce obesity with the fewest complications, control comorbid problems, and maintain weight loss over a long period of time.

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How does RNY GASTRIC BYPASS WORK?
Bile and Pancreatic Fluids

For almost 50 years scientists have tried to develop a variety of methods / techniques for this purpose.

A 50-60cc pouch is created at the top of the stomach, where the "satiety" signals are produced. The first effect of the procedure is the feeling of "early satiety" with the intake of "small portions of food". The small intestine is connected under this gastric pouch, and the second important effect of the procedure is to reduce the mixing of some of the calories taken into the blood, by deactivating the initial part of the small intestine, which has a high "food absorption capacity". The Rny gastric bypass procedure has been used in obesity surgery in the USA since 1991.

WHY CAN'T I LOSE WEIGHT WITH THE DIET I DO?

In adults, the gastric volume is 600-900cc and takes 2-3 portions of food. When the stomach is full, a “feeling of fullness” occurs. “Restricting food/calorie intake” is essential in diets applied to lose weight. Unfortunately, when the stomach is not full, dieters do not feel "satiety" and leave the diet.
For the feeling of fullness, it is possible with less food, either by "full filling" of the stomach or by a "small pouch" in the stomach.
It is a technique accepted as the "gold standard" in bariatric and metabolic surgery, in which both "restrictive" and "malabsorptive" mechanisms are used together.
Morbidly obese (BMI>40) people have a <2% chance of falling to the “ideal BMI” with diet and exercise alone.
The success rate of Roux-en-y Gastric bypass surgery in bariatric surgery is close to 90% on average.

IS OBESITY SURGERY SAFE DURING THE CORONA VIRUS PANDEMIC?

Patients with metabolic disorders like cardiovascular diseases, diabetes and obesity may face a greater risk of infection of COVID-19 and it can also greatly affect the development and prognosis of pneumonia

Source: (https://pubmed.ncbi.nlm.nih.gov/32386567)

Studies have also shown that prior bariatric surgery conveys protection against mortality from COVID-19 and that obesity is the biggest risk factor for mortality from COVID-19 infection in adults. Bariatric surgery has been safely performed in patients who made a full recovery from COVID-19 without increased complications due to cardiovascular, pulmonary, venous thromboembolism, or increased mortality rates.

Source: (https://pubmed.ncbi.nlm.nih.gov/34446386/ )

The following positive results were also reported in the Italian study; Introduction of strict COVID-19 protocols concerning the protection of patients and health-care professionals guaranteed a safe response of elective BMS in Italy. The safety profile was, also, maintained during the second wave of outbreak, thus allowing access to a cure for the obese population.

Source: (https://pubmed.ncbi.nlm.nih.gov/34133962/)
WHICH SURGEON SHOULD I CHOOSE FOR MY RNY GASTRIC BYPASS SURGERY?

Obesity The most important criterion in Bariatric and Metabolic surgery is the choice of surgeon. Surgeons who have performed a total of 400 or more bariatric surgical procedures according to IFSO criteria are considered "expert surgeons". Your surgery will be performed by Expert Bariatric Surgery Specialist, Ersun Topal, MD, General Surgeon. He has 9 years of bariatric surgery experience and >1500 cases (sleeve gastrectomy, rny gastric bypass, omega/mini gastric bypass, sadi-s, duodenal switch-biliopancreatic). diversion, revisionally surgery) has extensive experience and is a member of IFSO and Turkish Obesity Surgery Society

Source: (http://www.turkishobesitysurgery.com/information)( https://www.ifso.com/)
Bile and Pancreatic Fluids
HOW IS RNY GASTRIC BYPASS DONE?

With the laparoscopic technique, 4 holes were made in the abdominal wall.

Bile and Pancreatic Fluids Rny-Magenbypass-Operation

A gastric pouch is created to have 50-60cc in the stomach.

Small intestine

The first 60 cm area with a very high absorption capacity in the small intestines is disabled.

closed for the grocery entrance

A new path is made between the small intestine 61 cm-stomach pouch.

closed for the grocery entrance

Anatomy after Rny Gastric Bypass

closed for the grocery entrance
closed for the grocery entrance

IS ROUX-EN Y GASTRIC BYPASS A RELIABLE PROCEDURE?

Among the bariatric surgical techniques, it is a low-risk bariatric surgery procedure. The surgeon's experience and the quality of titanium staples used are very important. Only U.S FDA (Food and Drug Administration; The FDA is responsible for protecting the public health by ensuring the safety, efficacy, and security of human and veterinary drugs, biological products) approved Medical Device Company Endoscopic Staples is used in our clinic.

Source: (https://pubmed.ncbi.nlm.nih.gov/34133962/)

Absolutely replica/cheap Chinese brands staples are not used!!

WHY SHOULD I PREFER ISTANBUL BARIATRIC CLINIC?

a-Surgeon's experience (+1500 bariatric and metabolic surgeries)
b-Using FDA approved Medical Device Company Tri-Staples Tech stapler

Source: (https://www.medtronic.com/covidien/en-us/products/surgical-stapling/tri-staple-technology.html)
WHAT ARE THE RISKS OF RNY GASTRIC BYPASS?

laparoscopic rny gastric bypass surgery mortality rate 0.22 %.
The suture line leakage rate 0.8%
Post-operative bleeding rate 2.4%
Cardiopulmonary complications rate 1.3%

Source: (https://pubmed.ncbi.nlm.nih.gov/27189352/) (https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5187372/)
WHAT SHOULD I DO BEFORE RNY GASTRIC BYPASS?

You must stop all painkillers (ibuprofene, diclophenac, Naproxen and etc non-steroidal anti-inflammatory drugs) except Paracetamole. You should start to drink 1 of the over-the-counter Proton Pomp Inhibitor drugs (Pantaprasole, Esomeprazole, Lansaprasole ext.) every morning on an empty stomach

IS CHECK-UP REQUIRED BEFORE RNY GASTRIC BYPASS PROCEDURE

Before obesity surgery, blood tests, chest X-ray, Electro-cardiography, upper gi endoscopy (with and under sedation anesthesia) will be performed. If you have heart disease or diabetes, you will be consulted.

Frequently Asked Questions

You will not pay extra-charges for the “standard tests and examinations” that must be done before the surgery.

Before your surgery begins, pre-medication will be administered to control analgesia. Also “A patient controlled analgesia (PCA) system allows you to give yourself a dose of intravenous pain medicine, with the push of a button. This system decreases any pain and anxiety you may feel while waiting for medicine.

Source: (https://www.mayoclinic.org/patient-controlled-analgesia-pca/img-20008231#:~:text=A%20patient%20controlled%20analgesia%20(PCA,feel%20while%20waiting%20for%20medicine)

In bariatric and metabolic surgery, the quality of the stapler to be used determines the quality of the surgery. Only Medical Device Company Tri-Staple Tech original American product is used in our clinic. We definitely do not use the cheaper Chinese made staplers.

After your surgery, you will start feeding with foods prepared by your Bariatric Surgery Dietitian in accordance with the “AACE/TOS/ASMBS Guidelines Clinical Practice Guidelines for the Perioperative Nutritional, Metabolic, and Nonsurgical Support of the Bariatric Surgery Patient”.

Source: (https://asmbs.org/app/uploads/2014/05/AACE_TOS_ASMBS_Clinical_Practice_Guidlines_3.2013.pdf)

Our Bariatric Surgery Dietitian, who is part of our clinical team, will follow you online free of charge for the first year.

Early mobilization of patients is recommended 4 hours after bariatric surgery.

Our clinical nurses will take care of you closely. A company will not be required.

After bariatric surgery, you will be discharged from the hospital after 48 hours under routine conditions.

You can shower 48 hours after laparoscopic bariatric surgery.

After being discharged from the hospital, Istanbul or Bursa, Iznik (Iznik is the place where the first ecumenical (universal) council of Christianity was held. In other words, in 325 AD, 228 bishops from all over the world attended and the basic principles of the Christian religion were discussed and decided. The only church accepted by the Christian sect, St. Koimesis Church, St. Neophytos Basilica) Ephesus, Meryem Ana church can be visited.

There is no obstacle for you to travel by car or plane after being discharged from the hospital after bariatric surgery.

There is no obstacle for you to travel by car or plane after bariatric surgery.

After bariatric and metabolic surgery, there is no obstacle to activities such as walking, jogging, cardio, yoga in the first week, swimming running spinning from the 2nd week, pilates, step, aerobic, zumba, weight lifting from the 3rd week.

Laparoscopic entrance holes will be closed with aesthetic technique, the rate of wound infection is very low, it does not require wound care.

There is no obstacle/restriction in terms of sexual intercourse after obesity and bariatric surgery.

There is no medical obstacle to getting pregnant after losing your excess weight in the first 18 months following bariatric and metabolic surgery.

Do not neglect to do sports to prevent skin sagging after obesity surgery.

Post-bariatric aesthetics after bariatric surgery can completely change depending on the demands of the patients. It may be needed in some patients.

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