So what is blue and white gastric bypass or gastric bypass it is a bariatric or a weight loss surgery which is most often done in a minimally invasive fashion most commonly laparoscopic or Keyhole and sometimes robotic it’s a irreversible procedure It’s very effective in almost 90 percent of the cases it’s ideally suited for people who are not only obese but also have other comorbidities or medical issues such as diabetes high blood pressure and sleep apnea particularly those who have moderately severe diabetes the complication rates range anywhere between five to ten percent which are mainly leaks infection and bleeding but also unlike sleeve gastrectomy it also has slightly higher rates of GI complications which include dumping diarrhea constipation and vitamin deficiencies historically speaking it was initially introduced in 1950s but from 1950s to early 1990s it went through few Transformations and few techniques were experimented the modern Keyhole surgery the modern bypass surgery was first performed in 1994 in a laparoscopic fashion and since then it has gained popularity all over the world.

So who actually qualifies for this according to the new international guidelines anybody who has a BMI or a body mass index of more than 30 qualifies for a bariatric surgery but what type of surgery is ideally suited depends on several factors it needs to be discussed between the patient and the specialist partially speaking it depends on body mass index anybody with a severe or severely obese or morbidly obese is ideally suited for bypass anybody with medical issues or medical comorbidities such as diabetes high blood pressure Pro sleep apnea is ideally Suited at the same time it needs to take into consideration whether the person undergoing surgery has reflux or not so how actually does it work classic bypass involves forming a small pouch cutting out majority of the stomach aside this small patch induces satiety and decreases appetite the other mechanism is it also increases two other hormones known as cholecystoconin and pancreatic peptide in the small bowel it increases the production of these enzymes or these hormones these are known to be appetite suppressants additionally a bypassed segment of proportion of the small ball between the stomach and the second joint also doesn’t participate in digestion or absorption leading to weight loss it is normally done in a keyhole fashion using either four or five ports either laparoscopically or robotically where the operation starts off by creating a small patch just below the food pipe lower down in the small bar the small ball is divided the cut end of the lower part of the small ball is then brought up to the pouch and anastomosed or joint and the second joint is then created between the cut tent of the small bar and the loop of the small ball that is brought up to the stomach thereby creating a bypass which looks like the alphabet y and that is that’s why it is called as ruin y bypass this also creates as I said before a segment of small ball or a proportion of the small ball between the stomach and the second joint which is represented by color yellow here which doesn’t participate in any calorie or mineral or vitamin absorption leading to weight loss is there only one type of bypass there are several types of bypass but true and why bypass is the most common uh bariatric surgery among the bypasses the other bypass that is gaining popularity and traction is called one anastomosis bypass where the gastric pouch is slightly narrower and thinner compared to the pouch that is created in blue and white bypass one an osmosis bypass has only one joint where the loop of the small ball is brought up to that stomach pouch and anastomos or joint again creating a segment of the small ball between the stomach and the joint which doesn’t participate in any absorption or digestion of the food that we eat how does it compare to other popular bariatric surgery namely sleep it is slightly it achieves slightly higher excess weight loss so what is excess weight loss considering 25 BMI as the ideal any weight above the BMR 25 is considered as excess weight and we talk in terms of the percentage of excess weight loss that can be achieved by doing a particular bariatric procedure the weight loss is consistent the success rates are about 90 percent and its effects on the diabetes is probably higher than the Sleep especially when it comes to moderately severe diabetes in terms when when it comes to diabetes mild diabetes or severe diabetes probably has the same effect from sleeve and bypass from the research that has been conducted the complications rates are slightly higher in the range of 5 to 10 percent the nutritional deficiencies on nutritional consequences are higher and that’s why it is absolutely important to keep an eye on the minerals vitamins and take supplements as a part of your daily protein the other smaller complications or side effects are mainly in terms of the GI complications such as constipation diarrhea sometimes swallowing difficulties and occasionally especially in the early stages after the operation dumping is another phenomenon that is noticed following the bypass in terms of the follow-up long-term follow-up is ideal bought by the surgeon as well as the dietitian especially this is important in the first two years because the weight loss is maximum in the first two years and after this the weight starts to either Plateau or increase if at all it’s going to increase so ideally lifelong follow-up is the best way to achieve the ideal outcome that is preferable surgery helps with the physiology of the appetite but it doesn’t fix other problems such as poor nutritional choices and behavioral eating that is sometimes the cause of obesity so lifestyle and eating habits must change for long-term outcomes finally surgery along with the lifestyle changes or behavioral change changes as I have mentioned before gives you the success sustained success and it’s a recipe for long-term positive outcome.