Synonyms in a broader sense
Gastric reduction, gastroplasty, tubular stomach, Roux en Y bypass, small intestine bypass, biliopancreatic diversion according to SCOPINARO, billiopancreatic diversion with duodenal switch, gastric balloon, gastric pacemakerThe principle of biliopancreatic diversion is similar to Roux en Y bypass. It was developed by the Italian Nicola Scopinaro in 1976. This method is also very demanding and requires an experienced surgeon.
Procedure
This technique is also much more invasive and complex than gastroplasty or gastric banding. However, the weight loss is also very large. In biliopancreatic diversion, the stomach is made smaller and the lower part is removed.
The stomach retains a residual volume of 200-250 ml. The new stomach outlet is sutured with a loop of small intestine. A large piece of intestine is left out to give the body less opportunity to absorb fats and carbohydrates from food.
Since the body still needs its digestive juices for digestion, another loop of small intestine must be added. This connects the upper small intestine (lower part of the duodenum), where the juices enter, with the part from the stomach. Thus, digestive juices and food have a common channel of about 50cm.
This method thus helps twice over with weight loss. The biliopancreatic diversion ensures an earlier feeling of fullness through the smaller stomach and less food is absorbed through the shortened path through the small intestine. The problem with biliopancreatic diversion is that the fore stomach has no sphincter.
This normally regulates how quickly the food leaves the stomach. Without it, the so-called dumping syndrome occurs. Sugar leaves the stomach too quickly and the body cannot regulate against it quickly enough. This leads to nausea and sweating. Even after this operation, you have to supplement vitamins and other nutrients for the rest of your life.
Billiopancreatic diversion with duodenal switch
The biliopancreatic diversion with duodenal switch is based on the biliopancreatic diversion. The effects of weight loss are not quite as great, but the disadvantages such as the dumping syndrome described above are eliminated. In this technique of biliopancreatic diversion, a smaller tubular stomach is formed, whereby the sphincter muscle at the exit of the stomach is retained.
This tubular stomach has a volume of approximately 80-120 ml. The tubular stomach is again sutured to a loop of small intestine. The upper part of the duodenum is closed and the lower part is sewn to the lower part of the small intestine so that the digestive juices can still reach the food.
The combined distance of food and juices (Commen Channel) is about 100 cm. As with the other methods mentioned, vitamins and other nutrients must be supplemented after this operation.