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Mini-bypass surgery is one of the methods of bariatric surgery, or weight loss surgery. Mini-bypass is one of the most popular surgical methods today, both in Estonia and elsewhere in the world, and is considered very safe. Bariatric surgery significantly impacts a patient’s dietary preferences and habits. After the surgery, patients achieve a sense of fullness and satiety with much smaller portions of food than before. As a result, body weight begins to decrease and several associated health conditions improve, such as type II diabetes, sleep apnoea, high blood cholesterol levels, hypertension, joint pain and other obesity-related diseases. Bariatric surgery is currently the most effective method with lasting results for treating obesity, significantly improving quality of life and extending life expectancy.
What is mini-bypass surgery?
Mini-bypass surgery can be divided into two stages. The first stage of the mini-bypass surgery is the division of the stomach. A small, tubular stomach with a volume of 50-60 mL is formed from a smaller part of the stomach. The remaining majority of the stomach is removed from the food pathway. As a result of the first stage of the surgery, only a small amount of food can be eaten at a time.
In the second stage, a section of the small intestine, approximately 150-200 cm long, is taken and connected to the lower part of the small, tubular stomach. The larger portion of the stomach and the initial part of the small intestine are excluded from the food’s path but are still connected to the digestive system. Through the new connection, gastric juice, bile and pancreatic enzymes are directed into the small intestine at a much later stage of digestion than usual. As a result of the surgery, food does not pass through about 150-200 cm of the small intestine before it begins to be absorbed. The average length of the small intestine is usually about 600 cm, or six metres, but after a mini-bypass, about 400 cm, or four metres, remains passable for food. The second stage of the mini-bypass surgery creates a so-called malabsorption component, i.e. reduced absorption of nutrients. In addition to various vitamins and minerals, the absorption of proteins and fats is also reduced to some extent, so the body gets less energy (calories) from food.
The main difference between a standard bypass surgery and a mini-bypass surgery is that in the case of a mini-bypass, only one new connection, or anastomosis, is made, while in the case of a standard gastric bypass surgery, two connections are made – the upper and the lower. Therefore, a mini-bypass can be performed faster than a traditional gastric bypass surgery and has fewer complications (there are also significantly fewer later problems – internal hernias, intestinal obstructions). There is also a difference in the length of the section of the small intestine that is bypassed. In the case of a standard bypass surgery, 100–150 cm of the first part of the small intestine is left out of the food path, while in the case of a mini-bypass, 150–200 cm of the first part of the small intestine is left out of the food path.
How does mini-bypass surgery work?
Mini-bypass surgery limits the amount of food you eat at one time, reduces nutrient absorption and changes the hormones that affect appetite. Mini-bypass surgery is very effective and essentially combines the methods of sleeve surgery and bypass surgery.
Mini-bypass surgery is restrictive. This means that the surgery reduces the size of the stomach, which limits the amount of food eaten, creates a feeling of fullness faster and helps to maintain a feeling of satiety for longer. In addition to the restrictive effect, the amount of energy (calories) obtained from food is reduced to some extent, since up to 180 cm of the small intestine is excluded from the food movement path, which somewhat changes the absorption of proteins and dietary fats. During the surgery, no organs or parts of them are removed and in the future it is possible to restore the previous anatomy.
Expected weight loss after mini-bypass surgery
Studies have shown that after two years, most patients have lost 75–85% of their excess weight. If more than five years have passed since the surgery, the corresponding results are 70–75%, which is why mini-bypass surgery is one of the best surgical methods of weight loss with a long-term effect. The expected long-term weight loss after surgery is somewhat greater with mini-bypass than with standard bypass and sleeve.
Achieving and maintaining a permanent and long-term lower body weight also depends significantly on the patient’s personal commitment. It is important to make the necessary healthy lifestyle changes to ensure that diet and exercise habits align with specialist recommendations.
Which patients should consider mini-bypass surgery?
* Patients with a BMI of 30 kg/m2 and comorbidities or a BMI of over 45 kg/m2.
* Patients with type 2 diabetes, as the probability of diabetes relief with mini-bypass is better than with sleeve or bypass surgery.
* Mini-bypass surgery is well suited for those whose one of the problems related to nutrition is excessive consumption of sweets.
* Patients who are highly motivated to follow instructions and recommendations, especially in the constant daily consumption of vitamin and mineral supplements.
Calculate your body mass index
Surgery information
| Surgeon | Dr Rein Adamson / dr Martin Adamson / dr Sven Troost |
| Indications by body mass index | BMI from 30, depending on comorbidities |
| Anaesthesia | General anaesthesia |
| Surgery duration | 1-1,5 hours |
| Nights spent in hospital | 1-2 |
| Necessary time of rest | 2 weeks |
| Expected weight loss | 75–85% of excess weight (long-term approx. 75%) |
| Advantages |
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| Disadvantages |
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| Reversible surgery | YES |
| Price | 6500 € |
Payment in instalments | From €146 per month. Apply for instalment payments here. |
Test your suitability
Advantages of mini-bypass surgery
- Since the surgery is technically simpler, complications are less common
- At least equivalent or even greater weight loss than standard gastric bypass
- The cure rate for morbid obesity-related diseases is remarkably good, especially for type 2 diabetes (relieved in 80% of cases)
- Compared to other similar procedures, mini-bypass surgery has fewer episodes of abdominal pain
- The former anatomy can be restored
Disadvantages of mini-bypass surgery
- Potential for vitamin and mineral deficiencies
- More common problems with iron deficiency and the resulting anaemia
- Gastrointestinal symptoms related to food intolerance may occur, such as diarrhoea, excessive gas, etc.
- Some risk of stomach ulcers, especially with regular painkiller use and smoking
- 1% of patients may develop serious nutrient malabsorption, which may require corrective surgery in some cases.
What is included in the price
- Service and support from an English-speaking patient coordinator throughout the entire process.
- You will be supported by experienced English-speaking medical professionals, surgeons, and additionally specialists, including a bariatric nurse, a dietitian, and a therapist specializing in solution-focused brief therapy.
- Remote consultation with a surgeon in English before the surgery (30 min) (paid separately but deducted from the surgery cost).
- Consultation with a bariatric nurse before the surgery and during the hospital stay.
- Support from the bariatric nurse throughout the process as needed, flexibly for two years after surgery. Later, there is the possibility to contact them if any questions arise.
- Nutrition counseling with a licensed dietitian before surgery and at 3, 12 months after surgery (online or by phone).
- All transfers between Tallinn’s port, airport, hotel, and hospital.
- One-night stay in a central Tallinn hotel before the surgery if necessary.
- Blood tests and examinations related to the surgery before the operation and if necessary afterward (before discharge from the hospital).
- Surgery and laparoscopic stomach examination under anesthesia, performed by an experienced surgeon in a modern and comfortable private hospital. Support from a bariatric nurse upon arrival at the hospital and as needed during hospitalization. Nutrition counseling before discharge.
- All costs related to the surgery and hospital stay (usually one night, if necessary, two nights). The possibility to spend a second night in a high-quality central hotel if the patient’s condition allows.
- Written post-surgery care and nutrition instructions. A medical report in English.
- Follow-up call from the surgeon after discharge.
- Bariatric nurse contact via email at 1.5 weeks, 1 month, 6 months, 12 months, and 24 months after surgery. The possibility to contact the bariatric nurse flexibly via email and to arrange a phone consultation if needed.
- Blood tests related to nutritional monitoring before surgery and three times after surgery in Estonia. If needed, also the possibility of a follow-up visit with the surgeon and consultation with the bariatric nurse.
- Two consultations with a solution-focused brief therapy therapist to strengthen lifestyle changes within two years after surgery (one 45-minute session before surgery, recommended one session within six months post-surgery).
- Treatment of possible complications, provided the treatment is performed at the same hospital where the surgery was conducted. Discounted prices at our clinic for post-bariatric plastic surgery (abdominal, arm, thigh, and breast surgery).
- Active support and follow-up before surgery and for two years after the operation. Final summary and recommendations. The possibility to always contact our clinic, even after two years, if any questions arise.
