Candidates tend to have a BMI over 40, or a BMI between 35 and 40 with accompanying diseases such as diabetes, sleep apnea, cardiomyopathy (heart damage) or severe joint degeneration and pain. They should have a long record of failed previous non-surgical weight loss interventions (diet, exercise) before considering gastric bypass.
Patients who have current drug and alcohol abuse, a history of binge eating, untreated major depression or psychosis, severe cardiac disease, or disorders that interfere with healing such as blood clot disorders are not good candidates. Mini gastric bypass should not be considered a first-line option for weight loss and should be considered only after exhausting non-surgical weight loss options.
Candidates who may be especially susceptible to gastrointestinal reflux disease (GERD) and who desire having “dumping syndrome” as a negative reinforcement to facilitate weight loss may not be good candidates for mini gastric bypass.
The rates of GERD may be higher in mini gastric bypass compared to the traditional method, since the new stomach pouch created by mini gastric bypass is exposed to acidic digestive juices.
You may be asked to change your diet, lose or maintain a stable weight, or alter your dietary habits (e.g. eating smaller meals throughout the day) before surgery. This increases your chances of successful, sustained weight loss after the surgery. Like other surgeries, mini gastric bypass may require you to undergo certain general surgery procedures such as preoperative blood testing, medications, and cessation of smoking or use of pain relievers and anti-inflammatory drugs.
Recovery is a slow and gradual healing and readjustment process as you adjust to eating smaller portions of food. Pain in the first 2-3 days after surgery in the upper left part of the abdomen is common, but can be managed with pain relievers. Pain should be minimal to nonexistent by 2-3 weeks after the surgery. Although light walking is suggested soon after surgery, strenuous exercise should be avoided for the first few weeks.
Patients should stick to an all-liquid diet for the first week, before gradually easing into soft foods and eventually, back to a normal diet. However, portion sizes should be heavily restricted and patients should eat slowly in order to accurately gauge their satiety and fullness. It’s important that lifestyle changes implemented before the surgery be maintained long-term.
Risks are similar to gastric bypass surgery, but are overall lower due to the decreased complexity of the surgery. The most common complications from mini gastric bypass surgery are nausea and vomiting, malnutrition (as the surgery results in malabsorption of nutrients to reduce calorie consumption), gallstones, and internal hernia. Nausea and vomiting are not true complications, but do occur in 50% of patients postoperatively.
Major complications occur in less than 3% of procedures. These include bowel obstruction, staple line leak, internal hemorrhaging, and pulmonary embolism. As with any surgery, there is a risk of complications related to infection or adverse reactions to anesthesia. A proper assessment of every patient, along with complete lab work, will help to prevent postoperative complications.
Mini gastric bypass carries an increased risk of gastrointestinal reflux disease relative to gastric bypass, as the loop created that bypasses the stomach is still connected to the intestines, allowing digestive juices to travel into the new stomach pouch.