There are two components created by this laparoscopic operation. The first is that the gastric pouch has less curvature and is thereby more restrictive. The second is a jejunal bypass that is 200 cm or longer and features a single anti-colic gastrojejunostomy anastomosis, leading to a significant reduction in fat absorption. The surgeon inserts an endoscopic cutter/stapler through the trocars to split the stomach into two sections. The smaller section becomes your “new stomach.” It stays connected to your esophagus and the surgeon reshapes it into a narrow tube, similar to the shape of vertical sleeve gastrectomy. The new mini bypass stomach will hold between four to six ounces of food, compared to the old stomach holding 40 ounces of food.
The lesser curvature is defined where the body and the antrum meet and the stapler division is created at a right angle from this lesser curvature, and then upwards parallel to it. The surgeon divides the stomach laterally toward the gastroesophageal junction. Unlike when it comes to the sleeve gastrectomy operation, cardio is avoided explicitly. The larger section of the stomach that was split from your “new stomach” remains intact and alive within your body. It becomes important to produce digestive fluid which will help the digestion process, although will not hold food again.
This digestive fluid travels through the small intestine, connecting to the point at which food is digested through the “new stomach”, therefore breaking down the food as it continues through the intestine. Then, the bariatric surgeon will examine the length of your small intestine, to measure the amount that will be bypassed. This section of the small intestine will include both the duodenum and a section of the jejunum. It generally is bypassed 5-6 feet from the point at which the larger stomach, or “old stomach”, connects to the small intestine.
When creating the 200 cm long malabsorptive jejunal bypass, the surgeon turns their attention to the left gutter, retracting the omentum medially so that they may identify the Treitz ligament. They run the bowel 200 cm distal to this ligament, at which point the gastric sleeve’s distal tip is anastomosed anti-colic to the jejunum end side. Your surgeon will determine the length that is bypassed based on lifestyle, habits, health, and physical condition. Finally, the surgeon begins the connection between the “new mini stomach” to the small intestine that is bypassed, using a stapler. This connection point is called an anastomosis. Once finished, the mini gastric bypass surgeon will reinforce and stabilize the anastomosis with sutures, finishing the procedure with sutures on the trocar insertion parts of your abdomen.