Gastric loop bipartition is a relatively new anti-obesity technique first announced by Professor Sergio Santoro, in 2012. The operation follows the logic of the classic gastric bypass that wants to promote indigestible food to the distant small intestine (ileum) for the treatment of diabetes. Indeed, the promotion of indigestible food in the ileum has been shown to stimulate the secretion of enteroglucagon (GLP-1) and other peptides that control appetite and improve glucose metabolism (= treatment of diabetes). With known gastric bypass surgery, the anatomy of the digestive tract is altered to push all the food to the final part of the intestine.
The disadvantage of bypass surgeries is that they cause malabsorption of micronutrients (vitamins, minerals) and patients need lifelong dietary supplements. Another disadvantage of bypass surgeries is that they block access to the duodenum, so they must be accompanied by cholecystectomy. Questions are about the future dangers of the excluded part of the stomach.
The Gastric loop bipartition is a compromise solution with an emphasis on eliminating the disadvantages of bypass. This is an original “metabolic” operation that combines the bariatric effectiveness of a gastric sleeve with the metabolic benefits of intestinal bypass. A loop of gastro-intestinal anastomosis is added to the gastric sleeve to divert part of the food to the final small intestine (ileum). The sleeve limits the amount of food that then has two paths to follow. 70% of the food is diverted indigestibly to the ileum, while 30% follows the normal path through the duodenum.
GASTRIC LOOP BIPARTITION – Advantages
The metabolic effect is equivalent to gastric bypass (GLP-1, PPY).
Gastric restriction and reduction of appetite, as in the gastric sleeve (reduction of ghrelin).
Less effect on the absorption of vitamins and iron (1/3 of the food passes through the duodenum.
It maintains the normal digestive tract
Less surgical risks and complications from gastric bypass.
Cholecystectomy is not necessary.
Who cares
People with high BMI who indicate gastric bypass, confectionery consumers, and diabetics. It is also a safe solution for people who have gained weight after a previous sleeve gastrectomy.
Advice
The 2-way operation must be performed by people with experience in the specific operation. There are critical technical details that affect the outcome.
