To Whom Sleeve Gastrectomy, To Whom Mini Gastric Bypass?

Obesity is a rising epidemic worldwide and bariatric surgery remains the main treatment method. The most common and applied bariatric procedure worldwide is laparoscopic sleeve gastrectomy (tube stomach). Tube Stomach surgery is basically a restrictive operation that maintains the continuity of the normal digestive system without any anastomosis. In sleeve gastrectomy surgery, approximately 2/3 of the stomach is removed.

Mini gastric bypass is also an alternative, safe, feasible and effective bariatric procedure. Mini Gastric Bypass is both a restrictive and absorption reducing method. Its popularity is increasing all over the world. A small stomach pouch is created and a new path is created by bringing the small intestine into this stomach’s empty space.

Sleeve gastrectomy and Mini gastric bypass surgery has its own advantages and disadvantages. Both operations are performed by closed method. Average operation times are equal in both methods. Hospital stay is equal after sleeve gastrectomy  and Mini Gastric Bypass surgeries. The possibility of developing reflux after sleeve gastrectomy surgery is higher than Mini Gastric Bypass surgery. Postoperative leakage is more likely in sleeve gastrectomy surgery. After bariatric surgery, weight gain may occur again and revision surgeries may be required. The need for back weight gain and revision after sleeve gastrectomy surgery is slightly higher than mini gastric bypass surgery.

There are many diseases that develop due to obesity. The most common of these diseases are high blood pressure, type 2 diabetes, sleep apnea and hyperlipidemia. The method we chose after obesity surgery should eliminate these concomitant diseases. In researches, Type 2 Diabetes, high blood pressure and hyperlipidemia disappear at higher rates than sleeve gastrectomy surgery after Mini Gastric Bypass surgery. There is no significant difference between them in sleep apnea. When sleeve gastrectomy and Mini Gastric Bypass surgeries are compared in terms of excess weight loss, it is seen that there is a little more possibility of excess weight loss after Mini Gastric Bypass.

In the light of this, what surgery should we recommend to which patient? To whom sleeve gastrectomy, to whom should we do Mini Gastric Bypass?

• Mini-Gastric Bypass surgery may be more suitable for obese people who have Type 2 diabetes and who use insulin for a long time.
• Mini Gastric Bypass surgery may be more suitable for obese individuals with severe reflux, since sleeve gastrectomy surgery will increase their reflux complaints.
• Mini Gastric Bypass surgery may be preferred because super obese individuals (50
• Mini Gastric Bypass can be preferred in obese people who have high sugar consumption.
• Since sleeve gastrectomy surgery does not disrupt the human anatomy, this is an effective bariatric method that should be preferred except for the cases we have mentioned.

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