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Transit bipartition surgery was first introduced in 2012 by Brazilian surgeon Dr. Sergio Santoro and has become one of the most effective and powerful surgical techniques for treating both diabetes and metabolic disorders . This procedure can generally be summarized as performing a wide sleeve gastrectomy (LSG) followed by a gastric bypass. However, it differs from other surgical methods in several important ways. Before going into details, it is useful to briefly understand diabetes.
Diabetes is a condition in which glucose circulates excessively in the bloodstream while insulin, although present, cannot effectively transport glucose into cells. This condition can lead to serious long-term health problems. There are many treatment options available, and doctors evaluate factors such as the patient’s condition and comorbidities to determine the most suitable treatment. One of these options is transit bipartition surgery. Now, let’s take a closer look at what this procedure involves.
What Are the Types of Transit Bipartition Surgery?
Single Anastomosis Transit Bipartition
This is the technique we prefer because it involves a single anastomosis while providing results similar to the double anastomosis method :contentReference[oaicite:1]{index=1}. It also has fewer complications due to the reduced number of connections. The procedure includes a wide LSG and a single anastomosis approximately 250 cm from the ileocecal valve. Compared to mini gastric bypass (MGB), it is associated with fewer vitamin deficiencies, and the diabetes regulation success rate is around 90%.
An important advantage is that there is no blind stomach and the duodenum is not cut, allowing endoscopic access to both the stomach and bile ducts. However, since long-term results are still limited, the procedure is performed under special authorization in many countries.
Double Anastomosis Transit Bipartition
This was the original technique used. Similar to many surgeries developed in the early 2000s, it involves a wide sleeve gastrectomy followed by a gastric bypass :contentReference[oaicite:2]{index=2}. The main goal is to allow food to pass through two different intestinal pathways.
After performing LSG, the ileocecal valve is measured backward, and an anastomosis is created approximately at the 250 cm mark. Another connection is made at around 100 cm, creating dual pathways for food passage.
How Does Transit Bipartition Work?
Transit bipartition is a combination of restrictive and malabsorptive mechanisms. The sleeve gastrectomy reduces stomach volume (restrictive), while the bypass component reduces nutrient absorption (malabsorptive). This dual effect makes it a highly preferred surgical method among surgeons today :contentReference[oaicite:3]{index=3}.
What Is Transit Bipartition?
Transit bipartition is an advanced metabolic surgery typically applied to patients with type 2 diabetes, especially those who are not severely overweight :contentReference[oaicite:4]{index=4}. The aim is to reduce nutrient absorption and thereby decrease food intake.
Approximately 70% of the stomach becomes functionally inactive, helping regulate blood sugar levels. The removed or bypassed portion is also responsible for secreting appetite-related hormones. Additionally, two intestinal pathways are created, allowing food to pass through both routes. This reduces glucose absorption and increases insulin effectiveness.
Who Is Suitable for Transit Bipartition Surgery?
Not every patient is suitable for transit bipartition surgery :contentReference[oaicite:5]{index=5}. The procedure is specifically designed for type 2 diabetes patients. However, having type 2 diabetes alone is not sufficient. Patients must also have adequate insulin reserve.
Other criteria include:
- Body Mass Index (BMI) above 35
- Adequate overall health condition
- No severe metabolic disorders that contraindicate surgery
- Failure of non-surgical treatment methods
A detailed evaluation is required to determine whether the patient is a suitable candidate.
Advantages of Transit Bipartition Surgery
Transit bipartition surgery offers several advantages compared to other surgical techniques :
- Vitamin and mineral deficiencies are usually temporary (6–8 months)
- The digestive system largely remains functional
- Long-term results are close to those of a healthy individual
- Hemoglobin levels remain near normal
- Shorter hospital stay and recovery time
- No large surgical scars due to laparoscopic technique
Are There Any Risks?
When performed correctly and with proper post-operative care, transit bipartition surgery is generally safe :contentReference[oaicite:7]{index=7}. However, some patients may experience mild weight regain depending on lifestyle factors. This can usually be managed with diet and exercise.
Post-Operative Care
After surgery, a structured diet is required for 1.5–2 months:
- Liquid phase
- Puree phase
- Solid phase
Patients must also take vitamin and mineral supplements for a certain period. Regular monitoring of biochemical values is essential.
Cost of Transit Bipartition Surgery
It is not possible to provide a fixed price for transit bipartition surgery :contentReference[oaicite:8]{index=8}. Costs vary depending on factors such as the surgeon’s experience, hospital conditions, and surgical technique. A detailed examination is required for accurate pricing.
Hospital Stay and Recovery
Patients are usually hospitalized one day before surgery for tests. After the operation, they are mobilized within 4–6 hours and start drinking water the next day. Discharge typically occurs on the third day.
Return to Work
Patients are generally able to return to work within 10 days after surgery, depending on their recovery and overall condition :contentReference[oaicite:9]{index=9}.
For more information, you can contact:
Landline: 0212 230 20 08
Mobile: 0505 120 82 62
