According to the World Health Organization, a person is considered obese if their body mass index is greater than 30.
Obesity is now a pandemic, and preventing it is a public health issue.
In order to slow the progression of this chronic disease, several techniques have been developed, whether medical or surgical.
Among the surgical techniques, gastric bypass is mentioned as a radical technique.
It is a bariatric surgery that involves changing the transit of food by reducing the volume of the stomach.
Indeed, gastric bypass allows to short-circuit the stomach by passing food from a stomach bag directly to the small intestine.
This intervention is irreversible.
It is a restrictive and poorly absorbing technique
The patient may use gastric bypass in several cases:
A body mass index BMI 40 kg/m2 (massive obesity)
BMI 35 kg/ m2 so severe obesity associated with a complication that can be relieved by surgery (diabetes, high blood pressure, sleep apnea….)
Before gastric bypass surgery
Given the irreversible nature of the intervention, it is essential to thoroughly study the case before proposing a treatment plan.
The decision will therefore have to be approved by a multidisciplinary team including the surgeon, a dietitian and if necessary a psychologist.
Upon validation of the intervention, the patient will have to undergo several tests as part of his preoperative checkup, so he will be asked to perform a complete blood test and an esophagoduodenal endoscopy to study the different compartments of the digestive tract.
The patient will also be asked to perform clinical and radiological tests to assess cardiac and respiratory function.
Within 48 hours prior to the procedure, the patient should have a visit with the anaesthetist.
In order to avoid complications during the procedure, the patient should not take aspirin for 10 days before the procedure.
Oral contraceptives will be contraindicated one month before the procedure.
In the interest of patient health, it will be recommended to quit smoking at least two weeks before and after surgery.
Gastric bypass surgery
Anesthesia
- L’intervention de bypass gastrique a lieu sous anesthésie générale.
- Le patient devra donc être à jeun le jour de l’opération.
- L’intervention nécessite une hospitalisation de 6 à 7 jours
Le temps opératoire
The principle of gastric bypass is to short-circuit the natural flow of food by connecting the upper portion of the stomach to the middle portion of the small intestine through staples and thus without the removal of any organ.
- The time of the intervention varies between 1h30 and 3h.
- The procedure is performed by laparoscopy.
- The surgeon will then reduce the size of the stomach to a small upper pocket and connect it to the middle part of the small intestine.
- The result is a decrease in the amount of food ingested and a reduction in transit.
After gastric bypass surgery
Postoperative course
Since the procedure is performed by laparoscopy, postoperative pain is rare.
Given the anatomical change there is a risk of vomiting, however the adaptation is done quickly.
Possible complications
Gastric bypass surgery in Tunisia is performed in well-equipped facilities by competent surgeons.
However, there are complications:
- Ulcer, leakage or narrowing of the junction between stomach and small intestine
- Hemorrhages
- Intestinal occlusion
- Dietary deficiencies
- Functional complications such as hypoglycemia after meals, constipation.
Recommendations
Even if the gastric bypass does not force the patient to any dietary restrictions, the latter will have to follow a fairly rigorous diet taking into account the acceleration of his transit.
It is recommended to reduce food portions in each meal.
In order to adapt the patient should eat liquid meals for a week then a molin diet the second week and mixed from the third week.
During the first three months after surgery, the patient will be advised to mix the meat.
It is also recommended to chew well.
The patient will have to follow new eating habits
- Eat only small amounts
- Eating meals sitting
- If the patient feels full he should stop eating
- Do not drink while eating
- Have a balanced and varied diet
Post-operative follow-up
After a gastric bypass is performed, the patient must attend the recovery consultations prescribed by the surgeon.
The first consultation will take place the day after the surgery, so that the surgeon can reassure the patient about the smooth progress of the procedure and answer his questions.
A nurse will be responsible for providing nursing care at the hotel.
Medical follow-up is important after a gastric bypass so the patient will be asked to:
- Conduct a quarterly blood test to identify dietary deficiencies
- Perform an ultrasound or x-ray every year to verify the correct functioning of the new food circuit
The patient should seek advice from the surgeon in case of a problem, the surgeon will answer their questions and address it to a colleague who represents them or contact their attending physician directly.
Result Gastric bypass in Tunisia
The final result is observable only after a period of 12 to 18 months, it is the time necessary for the body to reach a weight stability.
Indeed, during this period we witness a significant weight loss.
Conditions that accompany obesity, such as high cholesterol, are declining.
The gastric bypass allows a weight loss that varies between 70% and 75%, which corresponds to 35 to 40 kg in the first year.
Rate Gastric bypass in Tunisia
The price of a gastric bypass in Tunisia is on average around 4900 €
