Gastric reduction, gastroplasty, gastric tube, Roux En Y bypass, small bowel bypass, biliopancreatic version after SCOPINARO, biliopancreatic diversion with duodenal switch, gastric balloon, gastric pacemaker
The biliopancreatic diversion is similar in principle to the Roux en Y Bypass. It was developed by the Italian Nicola Scopinaro in 1976. This method is also very demanding and needs an experienced surgeon.
Also, this technique is much more invasive and expensive than gastroplasty or gastric banding. The weight loss is also very big. Biliopancreatic diversion shrinks the stomach, removing the lower part. The stomach retains a residual volume of 200-250 ml.
The new stomach outlet is sutured with a small intestine loop. A large piece of intestine is left out to give the body less opportunity to absorb fats and carbohydrates from food. Since the body nevertheless needs its digestive juices for digestion, another small intestinal loop must be displaced. This connects the upper small intestine (lower part of the duodenum) into which the juices enter with the part from the stomach. So digestive juices and food have a common distance of about 50cm. This method helps with weight loss twice.
The biliopancreatic diversion provides a feeling of fuller satiety through the smaller stomach and less food is absorbed through the shortened pathway through the small intestine. In biliopancreatic diversion, there is the problem that the forestomach does not have a sphincter. This usually regulates how fast the food leaves the stomach. Without him, it comes to so-called dumping syndrome . Sugar leaves the stomach too fast and the body can not regulate it fast enough. This leads to nausea and sweating. Even after this surgery, you need to supplement vitamins and other nutrients for the rest of your life.
Biliopancreatic diversion with duodenal switch is based on biliopancreatic diversion. The effects of weight loss are not that great, but the disadvantages like the dumping syndrome described above are eliminated.
In this technique of biliopancreatic diversion, a smaller tubular stomach is formed, maintaining the sphincter at the exit of the stomach. This tube stomach has a volume of approx. 80-120 ml. The tube stomach is sewn on again to a small intestine loop.
The upper part of the duodenum is closed and the lower part is sutured to the lower part of the small intestine so that the digestive juices can still come to the food. The common range of food and juices ( Commen Channel ) here is about 100 cm. Like the other methods mentioned above, vitamins and other nutrients must be supplemented after this operation.