gastric bypass surgery costWith extremely severe obesity and unsuccessful attempts to keep weight under control, the doctor in Israel may recommend surgery - BPD / DS - Biliopancreatic bypass (BPD) with duodenal switch. Its main task - to reduce body weight and diseases related to overweight - heart and vascular disease, hypertension, type 2 diabetes mellitus. The procedure restricts the amount of food and greatly reduces the absorption of nutrients from the digestive tract. Food is processed so fast that it is even less time for the absorption of nutrients. The volume of the stomach after BPD / DS - 150-250 ml, the length of the active tract (where the food and digestive juices are combined) is 75-100 cm.

BPD / DS - a complex bariatric surgery, one of the most effective. It provides long-term weight loss, but at high risk for nutritional deficiencies. If untreated, this condition can be life-threatening. Biliopancreatic bypass creates the greatest malabsorption, which provides on the one hand - losing weight, on the other - the risk of malnutrition and diarrhea. Limiting nutrient absorption is achieved because much of the intestines is aloof and not used. Therefore, when deciding whether it is necessary to carefully consider the potential risks along with the benefits.

What is BPD surgery in Israel?

BPD / DS may be formed as via laparoscopic or recessed approach. Open surgery involves the execution of one section, through which the surgery is performed, laparoscopic - 5-7 smaller incisions using special tools. Minimally invasive surgery promotes faster recovery, reduce the risk of complications.

People suffering from obesity, may not always be candidates for laparoscopic bypass Biliopancreatic. Contraindication is also carried out before surgery of the stomach or other serious medical problems.

Similarly as in the sleeve gastrectomysurgeon removes about 2/3 of the body it is the remaining volume of 100-150 ml. After that reconstructs the area where the food is mixed with digestive juices. Valve through which food passes from the stomach into the small intestine, is along the first part of the small intestine - the duodenum. Thereafter, the surgeon closes the middle portion of the intestine and connects the last part of the duodenum. Separation of part of the intestine remains in the body. It is attached to the end of the intestine, which move bile and pancreatic digestive juices. As a result of these changes, the food bypasses much of the small intestine, limiting the absorption of calories and nutrient absorption. This, together with the smaller size of the stomach leads to weight loss.

Indications Biliopancreatic bypass surgery in Israel:

  • BMI of 50 or more.
  • BMI of 40 or more with type 2 diabetes. Other health problems include: sleep apnea, heart disease, hypertension, high cholesterol, non-alcoholic fatty liver disease.

BPD with duodenal off - it is a complex procedure that solves the problem of weight loss through three mechanisms:

  1. It removes a large portion of the stomach to stop a person from overeating. With smaller volume body he will feel satiety faster and consume less food calories.
  2. The second mechanism is to redirect the food from the upper part of the small intestine, which prevents the absorption of nutrient and caloric intake.
  3. The third mechanism reroutes where bile and digestive juices are treated food. It also reduces the number of calories consumed, leading to weight loss. This malabsorption element - is more significant than in the gastric bypass.

Advantages of BPD / DS

The advantage with BPD off of the duodenum is rapid and substantial weight loss, as it reduces the amount of food and calories.

  1. There have been long-term weight loss, especially in patients with a high body mass index - BMI of 50 or more.
  2. Reduces the probability of ulcer development.
  3. Operation BPD is partially reversible for those who are experiencing serious problems of malnutrition.
  4. Virtually eliminates the dumping syndrome, as the pyloric valve is maintained.

Disadvantages BPD / DS

  1. High risk of chronic diarrhea and odor gas with flatulence.
  2. Increased likelihood of surgical side effects due to the complexity of the operation.
  3. High risk of deficiency of nutrients, leading to possible anemia, protein deficiency and metabolic bone diseases.

potential complications

If BPD surgery was performed by a cavity approach will need a much longer recovery period - 6-8 weeks. Says the greatest risk of infection due to the size of the cut, as well as the likelihood of a hernia.

BSHP off with duodenal carries a high risk of nutritional deficiencies after surgery. Reducing the intake of essential vitamins and minerals can lead to serious long-term complications. Anemia, osteoporosis, kidney stones.

After surgery, there is a lack of vitamin B12. The condition of patients be carefully monitored in connection with the question of deficiency of fat-soluble vitamins - A, D, E, K, and zinc. People who have had BPD / DS, are at high risk of a lack of calcium and iron.

Although rare deficiency of thiamine (vitamin B1) results in a vitamin deficiency, which can cause damage to the nervous system in the absence of treatment.

Approximately 18% of people after BPD / DS develops protein-energy malnutrition. In the severe form of this disturbance it is known as kwashiorkor - a potentially life-threatening form of malnutrition.

Biliopancreatic shunting off with duodenal ulcer is an invasive surgery. According to recent analysis, the death rate is 1.1% (1 of 100) for 30 days after surgery BPD.

After Biliopancreatic bypass required intake of vitamin-mineral supplements, regular blood tests to check for a possible deficiency of nutrients and the development of complications. Even if a person takes supplements as prescribed, still may be problems in the diet, requiring treatment.

As with any surgery, BPD carries certain risks:

  1. Internal bleeding.
  2. The development of infection.
  3. the formation of blood clots in the legs that can travel to the lungs or heart.
  4. Hernia.
  5. Death.

After surgery, bypass Biliopancreatic

After the BPD / DS to prevent nutritional deficiency Israeli doctors suggest the following for the reception of vitamins and minerals:

  1. Vitamin A, starting from 2 - 4 weeks after surgery.
  2. Vitamin D from 2-4 weeks.
  3. Vitamin K from 2-4 weeks.
  4. A multivitamin with 200% RDA from the first day after discharge from the hospital.
  5. From 18 to 27 mg of iron (50-100 during menstruation in women), starting with the first date of issue.
  6. Calcium supplements usually take 3-4 doses of 500-600mg extract from the first day and during the first month after surgery. Accepted a couple of hours after the iron.
  7. Vitamin B12 for 350-500mkg.
  8. Up to 3 servings of calcium rich dairy products.

It is also recommended to give preference to small but nutritious meals with high protein content along with fruits, vegetables, whole grains and omega-3 fatty acids. Avoid food with high sugar content.

It is important to understand that following a healthy lifestyle is crucial to maintain weight after surgery. This includes a healthy diet and regular exercise. And it's a lifetime commitment. should not be construed BPD / DS as a short-term process, which will help to lose weight quickly.