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PRICELIST

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  • Required BMI Starting from 35kg/m2
  • Expected weight loss 80-90% of excess body weight
  • Surgery time 1.5 hours
  • Hospital stay 1-2 days
  • Sick leave 2-4 weeks
  • Need for supplements Life-long need

The Bariatric Services is pleased to announce that we have implemented an innovative bariatric surgical procedure called Sleeve-Bypass/ gastric bypass with sleeve gastrectomy., also known as single anastomosis sleeve ileal bypass (SASI). This is the newest and highly effective weight loss intervention.

Sleeve-bypass is suitable for patients with a body mass index (BMI) of 35kg/m2 and above. It may also be considered for patients with a lower BMI who have obesity-related conditions such as type 2 diabetes, sleep apnoea, or dyslipidemia.

How does Sleeve-Bypass surgery work?

In sleeve-bypass surgery, the first step is a classic sleeve operation, where 80% of the stomach is removed longitudinally, leaving behind a banana-shaped tube with a capacity of 100-150ml. The removed section of the stomach is removed from the abdominal cavity. Then, an anastomosis is created between the remaining gastric tube and the middle part of the small intestine. This allows food to move through the stomach using two different paths: natural pathway through the pylorus and the duodenum and direct pathway through the new connection to the middle part of the small intestine.

Studies have shown that approximately 80% of the food bypasses the stomach and goes directly to the small intestine after the surgery, while 20% follows the natural pathway. In classical bypass surgeries, such as standard bypass and mini bypass, food is completely diverted from the duodenum and the beginning of the small intestine. In sleeve-bypass, however, the food continues to stimulate all parts of the intestines. The goals of this seemingly complex procedure are actually very clear, such as reducing the risk of vitamin and micronutrient deficiencies and minimizing the risk of bacterial overgrowth and resulting diarrhea in the bypassed section of the intestine. The surgery is performed laparoscopically, like other bariatric surgeries.

Sleeve-bypass is effective as a weight loss procedure because:

  • Reducing the stomach volume and the fact that 80% of the food bypasses the beginning of the small intestine leads to changes in intestinal hormone secretion. These hormonal changes affect our hunger, satiety, and food preferences, allowing weight loss without experiencing hunger or food-related stress as in a conventional diet.
  • Reducing the stomach volume enables an earlier and longer-lasting feeling of fullness. Food portions are small, and eating must be done slowly and with thorough chewing. The stomach capacity may increase slightly over a few months, but never to the previous level. Overeating or eating too quickly can cause discomfort in the stomach.
  • As a significant portion of the ingested food bypasses the small intestine, not all of it is digested and absorbed, especially in the case of fats. It is also well-known that food reaching the middle part of the small intestine directly from the stomach leads to a strong feeling of fullness, reducing appetite and influencing food choices.
Facts about Sleeve Bypass surgery

  • Advantages and risks

    Advantages of sleeve-bypass compared to standard or mini bypass surgeries:

    • Activation of intestinal hormones that contribute to rapid feelings of fullness and satiety, while also providing excellent blood sugar control in patients with type 2 diabetes. Up to 90% of type 2 diabetes patients achieve normalized blood sugar levels without medication.
    • Since a portion of the food follows the regular route through the duodenum, the risk of developing nutrient deficiencies decreases.
    • After this surgical procedure, there is a lower risk of hypoglycemia episodes (low blood sugar) compared to other surgical methods.
    • Sleeve-bypass results in significant and sustainable weight loss. Patients typically lose around 80-90% of their excess weight. 
    • The connection between the small intestine and the stomach reduces pressure in the new narrow stomach. This decreases the risk of developing heartburn compared to sleeve gastrectomy.
    • Lower risk of developing intestinal obstruction caused by an internal hernia.There is still the possibility to examine the remaining stomach and duodenum by conventional endoscopy if indicated. This is possible because completely bypassed sections of the digestive tract do not occur in this surgical method. It also allows for conventional  endoscopic access to the bile ducts and pancreas if needed..

    Risks

    • A small percentage of patients (approximately 4%) may develop an ulcer at the junction between the small intestine and the stomach. This risk is significantly higher in smokers and individuals who regularly use nonsteroidal anti-inflammatory drugs.
    • This surgical method carries a higher risk of developing heartburn compared to regular bypass surgery.

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Facts about Sleeve Bypass surgery

  • Advantages and risks

    Advantages of sleeve-bypass compared to standard or mini bypass surgeries:

    • Activation of intestinal hormones that contribute to rapid feelings of fullness and satiety, while also providing excellent blood sugar control in patients with type 2 diabetes. Up to 90% of type 2 diabetes patients achieve normalized blood sugar levels without medication.
    • Since a portion of the food follows the regular route through the duodenum, the risk of developing nutrient deficiencies decreases.
    • After this surgical procedure, there is a lower risk of hypoglycemia episodes (low blood sugar) compared to other surgical methods.
    • Sleeve-bypass results in significant and sustainable weight loss. Patients typically lose around 80-90% of their excess weight. 
    • The connection between the small intestine and the stomach reduces pressure in the new narrow stomach. This decreases the risk of developing heartburn compared to sleeve gastrectomy.
    • Lower risk of developing intestinal obstruction caused by an internal hernia.There is still the possibility to examine the remaining stomach and duodenum by conventional endoscopy if indicated. This is possible because completely bypassed sections of the digestive tract do not occur in this surgical method. It also allows for conventional  endoscopic access to the bile ducts and pancreas if needed..

    Risks

    • A small percentage of patients (approximately 4%) may develop an ulcer at the junction between the small intestine and the stomach. This risk is significantly higher in smokers and individuals who regularly use nonsteroidal anti-inflammatory drugs.
    • This surgical method carries a higher risk of developing heartburn compared to regular bypass surgery.

In conclusion

Sleeve-bypass surgery is an advanced and effective bariatric procedure performed under general anesthesia. Recovery typically takes  a day or two, similar to other weight loss surgeries. After the surgery, the use of vitamin and mineral supplements becomes a permanent part of daily life. Detailed recommendations may vary for each individual.

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