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Transit Bipartition surgery, first published in 2012 by Brazilian Dr. Sergio Santoro, has been one of the powerful and effective surgical techniques in eliminating both diabetes and metabolic disorders.
In general, this surgery, which can be summarized as a large LSG to the stomach and then gastric bypass, differs from other surgical operations in some aspects. We will explain what is curious about the surgery. But first, let’s talk about diabetes.
Diabetes is when glucose circulates in the blood at an excessive rate, and insulin hormone is not able to transfer glucose to cells even though it is sufficient. There are many different treatment options for diabetes, which can cause serious health problems in the long term. Doctors consider the patient’s current condition, comorbidities, and many other factors when evaluating treatment options.
In this way, the most appropriate treatment method for the patient is decided. One of these treatment options is the surgery in question. We will talk about who can benefit from this surgery or what advantages this operation offers. Just before, let’s consider more comprehensively what transit bipartition is.
What are the Transit Bipartition Surgery Types?
Transit Bipartition with Single Anastomosis
It is the type of surgery we prefer, because it is a single anastomosis and the results are the same as a double anastomosis. Also, in terms of complications, there are fewer complications due to the single anastomosis. Surgery is the method we do with a single anastomosis, numbered 250 from the wide LSG and ileocecal valve. It is said to be less vitamin deficient than MGB. Although leakage rates are less than other surgeries, diabetes regulation is around 90%.
The most important difference is that there is no blind stomach and the duodenum is not cut, so the patient can undergo endoscopic and biliary tract endoscopy. Nevertheless, since this surgery does not have long-term results yet, it is performed in most countries with special permission.
Transit Bipartition with Double Anostomosis
It was first done this way. In fact, like all operations performed in the 2000s, a wide LSG is applied to the stomach and then gastric bypass is performed. Unlike other surgeries, the purpose is to go food in two ways. The main thing is that after making a large LSG to the stomach, the ileocecal (where the small intestine and large intestine meet) walf (valve) is counted backwards and a mark is placed about 100 cm, continues to count and anastomosis is made to the stomach from about 250 cm. The remaining small intestine is anastomosed to 100 cm.
How Does the Transit Bipartition Effect Mechanism Work?
The reason why the surgical procedure performed to aid weight loss with Transit Bipartition has become a preferred surgery among surgeons due to its restrictive (due to tube stomach) and absorption-inhibiting feature (due to gastric bypass).
What is Transit Bipartition?
Transit bipartition surgery, which is a highly developed metabolic surgery method, is applied to people who do not have excess weight and have diabetes. The purpose of this surgical method is to disrupt absorption and thus reduce food consumption. We can say that the side effects related to the digestive system are limited. Approximately 70% of the stomach volume is rendered dysfunctional with the operation. The purpose of this is to control the patient’s blood sugar. At the same time, the part of the stomach is the region where the hormone that increases the appetite is secreted. The remaining part of the stomach is closed and the risk of leakage is reduced to a minimum level.
In the other stage of the surgery, a simple intervention is performed to the intestines and two different intestinal tracts are created. In this way, food consumption is reduced by 50% to 80%. The fact that foods pass through two different paths also reduces the amount of sugar that enters the blood.
At the same time, the amount of insulin hormone is increased indirectly. The operation in question must be performed by an experienced surgeon. In this way, it becomes possible to minimize the possible risks. In addition, we can state that the surgery can only be performed on patients who meet certain criteria. It is not a suitable surgical technique for every patient with diabetes.
Who Can Have Transit Bipartition Surgery?
First of all, we need to state that transit bipartition surgery cannot be performed on every patient. It is extremely important for the patient to comply with certain conditions in order to benefit from this operation. It should not be forgotten that the surgery in question is a special metabolic surgical technique. If patients are not suitable for this operation, other alternative methods may be preferred.
This surgery can only be applied to patients with type 2 diabetes. However, the patients having type 2 diabetes is not a sufficient criterion. At the same time, it is expected that the insulin reserves of the patient, in other words, their insulin capacity, are sufficient. This operation is also not suitable for patients whose insulin production is insufficient. However, the body mass index must be above 35. It should be noted that the age of the patients is also taken into account. The operation is performed according to the age and general condition of the patient.
Having health problems related to metabolism along with diabetes also makes patients not a suitable candidate. Therefore, the metabolic disorders present in the patient should be determined and evaluated carefully.
Finally, it is also important that patients have tried other non-surgical methods. If other methods that do not involve surgical intervention fail, this option is taken into consideration and surgery planning is made if the patient’s condition is suitable. The health status is taken into consideration in all aspects and as a result of a general evaluation, it is decided whether the patient is a suitable candidate for this operation.
Advantages of Transit Bipartition Surgery
Of course, patients are also curious about the answer to the question of what advantages transit bipartition surgery provides. This operation is a much more advanced method than all other digestive system surgery techniques. Therefore, it has some advantages for patients. We can cite the most prominent of these advantages in a short list:
- Vitamin and mineral deficiency problems are experienced for approximately 6 – 8 months, but at the end of this period, there is no need to take vitamin and mineral supplements regularly.
- In general, we can state that no part of the digestive system, except a part of the stomach, is made inert.
- In the long term, the results of the surgery are very close to a healthy person.
- Hemoglobin values in the blood will be very close to normal after the operation.
- Compared to many surgical interventions, the duration of hospitalization and recovery of patients in the clinical environment is much shorter.
- Since the surgery is performed with the method known as closed technique among the people, there are no long incision marks on the patient’s skin.
Of course, it is possible to add new ones to these advantages. However, we can state that the factors listed above are extremely important for patients who benefit from the surgery.
Are there any damages in transit bipartition surgery?
Transit bipartition surgery is not harmful if it is applied correctly and the patient follows the doctor’s warnings after surgery. Only a small amount of weight gain may occur in some patients, depending on the patient’s lifestyle. However, it is very easy to eliminate this problem with sports and diet programs. This disadvantage does not matter much, considering the harm that diabetes causes to patients. It should also be noted that the problem of being prone to weight gain is not seen in every patient.
In our experience, excessive weight loss is seen when the operation is applied to patients with a BMI below 35. For this reason, bowel measurement should be very good. Experience is very important here.
What Should Be Considered After Transit Bipartition Surgery?
A special diet should be applied for approximately 1.5 to 2 months after the operation. This diet consists of 3 stages in total. These;
- Liquid period
- Pure period
- Solid period
As in other operations, it is important to apply a gradual nutrition program in order to increase adaptation in this operation. During the liquid period, foods such as water, milk, ayran, soup, which we call clear liquid, are consumed. Egg, cheese, vegetable and fruit purees are started in the pure period. During the solid period, the patient’s tolerance is observed and the tulle foods are started slowly.
In addition, the patient’s biochemical data should be monitored in certain periods and vitamin and mineral supplements should be taken for the period indicated by the doctor. The period of need for vitamin and mineral supplements is limited, and if there is no problem in biochemical values, supplements are discontinued after a while.
Mild pain may be felt during the recovery period. In this case, medication should never be used indiscriminately, only pain medications prescribed by the doctor should be preferred. Different warnings or suggestions may be given depending on the general health status of the patients. These recommendations are very important for the patient to have a smooth recovery period.
How Much Are Transit Bipartition Surgery Prices?
Of course, there cannot be a clear figure on the transit bipartition surgery price. The reason is that providing a price information can be misleading for patients. First of all, surgery planning should be done in accordance with the patient. Many different factors, such as the experience of the doctor or the anesthesia method, mean that the price of this operation changes.
When patients do a price research, they may encounter very different figures. This situation is quite normal. In general, we can say that the surgery price offers reasonable figures, just to give an idea. However, for a clear price information, first an appointment should be made and necessary examinations should be done. You can write your questions about this operation in the comments section.
How Many Days Will I Stay In The Hospital After Transit Bipartition Surgery?
Our patients are usually hospitalized the day before for preoperative tests. The patient is walked 4-6 hours postoperatively. In the morning of the same day, our patient starts to drink water. After the tests, our patient is discharged on the third day of the operation. The reason for the patient to stay in the hospital for three days is that the patient is fully recovered and goes home in a healthy way.
When Can I Return To My Work After Transit Bipartition Operation?
Our patients, who are discharged on the 3rd day following the operation, are called for a control between 5-7 days. Their blood sugar levels are checked and they can return to work on the 10th day after Metabolic Surgery.
