Transit Bipartition Surgery
October 22, 2021 / By Nihat.Gulaydin-2021 / Posted in Obesity Surgery
Transit Bipartition surgery is performed by closed (laparoscopic) method. It is a combined restrictive and malabsorption technique.
In the first stage of the operation, a gastric sleeve is performed. In the second stage, the small intestines are marked by first counting up to 80 cm from the bottom, then counting continues and the 260th cm is marked. The small intestines are separated at the 260th cm. The separated lower part is brought and connected to the tubed stomach. The separated upper part is connected to the small intestine at the 80 cm mark previously marked. While 1/3 of the food continues to pass through the normal route, 2/3 passes through the small intestine section connected to the stomach.
What are the advantages?
Preventing low intragastric pressure and related gastric sleeve leaks
Due to the low pressure in the stomach, the sleeve gastrectomy procedure maintains its volume in the long term and prevents the long-term expansions seen in the sleeve gastrectomy procedure performed alone.
Since all areas of the small intestines can be accessed endoscopically, this technique does not have access problems to the gallbladder, pancreas and bile ducts, which are especially seen in techniques that disable the duodenum.
Less need for vitamin, mineral, iron and calcium supplements due to protection of the stomach antrum, pylorus and duodenum
What are the disadvantages?
Functional changes may be seen depending on the size of the connection route between the stomach and small intestine.
The simpler, single-connection version is preferred by many doctors. In this way, a simpler and shorter operation is performed. However, establishing a single connection may cause bile to be completely discharged from the small intestine into the stomach and cause chronic bile reflux.
Who can undergo Transit Bipartition Surgery?
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The purpose of Transit Bipartition surgery is to provide sugar control without medication (without insulin injections and/or pill treatment), especially in type 2 diabetic patients whose weight is close to normal or normal (low body mass index). In Transit Bipartition surgeries, sugar control is achieved while normal duodenal anatomy and structure is preserved. Thus, 1/3 of the nutrients pass through this route, preventing vitamin, mineral and nutrient absorption deficiency. With this procedure, diabetes is prevented by the patient's previously controlled pancreatic reserves.