Gastric Bypass SurgeryAbout The Procedure
Millions of individuals in the United States and around the world are overweight or obese (severely overweight). When weight increases to an extreme level, it is called morbid obesity. Obesity is associated with diabetes, heart disease, high blood pressure, some types of cancer, and other medical problems. Bariatrics is the field of medicine that specializes in treating obesity. Bariatric surgery is the term for operations to help promote weight loss. Bariatric surgical procedures are only considered for people with severe obesity and not for individuals with a mild weight problem.
There are several different types Bariatric Surgery procedures, but they are known collectively as Bariatric Surgery.
According to the American Society for Bariatric Surgery, Roux-en-Y (RYGBP) is the most commonly performed operation for weight loss in the United States. In the U.S, approximately 140,000 gastric bypass procedures were performed in 2005, far outnumbering the LAP-BAND, Duodenal Switch, and Vertical Banded Gastroplasty procedures.
Procedure Description
In Gastric Bypass Surgery the surgeon creates a small pouch at the top of your stomach and adds a bypass around a segment of your small intestine.
The surgeon staples your stomach across the top, sealing it off from the rest of your stomach. The resulting pouch is about the size of a walnut and can hold about an ounce of food. The pouch is physically separated from the rest of the stomach. Then, the surgeon cuts the small intestine and sews part of it directly onto the pouch.
This redirects food, bypassing most of your stomach and the first section of your small intestine, the duodenum. Food enters directly into the second section of your small intestine, the jejunum, limiting your ability to absorb calories. Even though food never enters the lower part of your stomach, the stomach stays healthy and continues to secrete digestive juices to mix with food in your small intestine.
Some surgeons perform this operation by using a laparoscope — a small, tubular instrument with a camera attached — through short incisions in the abdomen (laparoscopic gastric bypass). The tiny camera on the tip of the scope allows the surgeon to see inside your abdomen.
Best Candidates for Gastric Bypass Surgery
To qualify for Gastric Bypass Surgery, most patients must be morbidly obese, which usually means being overweight by 100 pounds (males) or 80 pounds (females) with a Body Mass Index (BMI) of 40+.
Bariatric Surgery may be appropriate if you are 80 pounds overweight and have a serious obesity-related condition like type 2 diabetes or life-threatening cardio-pulmonary problems such as severe sleep apnea or obesity-related heart disease.
The higher the motivation of patients to lose weight, and manage the post-operative requirements of dietary modification and behavioral therapy, the more successful Bariatric Surgery is likely to be, in solving their obesity and weight problems. This may influence the selection of candidates for Bariatric Surgery.
Compared with traditional "open" gastric bypass, the laparoscopic technique usually shortens your hospital stay and leads to a quicker recovery. Fewer wound-related problems also occur.
Length of the Procedure
Gastric Bypass Surgery takes 4 to 5 hours, depending on the extent of the procedure.
Anesthesia
Gastric Bypass Surgery is performed under a general anesthesia.
Inpatient or Outpatient?
Gastric Bypass Surgery is performed on an inpatient hospital. Most people typically stay in the hospital for a few days or less after surgery.
Possible Side Effects
If a person consumes sugar after a gastric bypass (ice cream, chocolate candy, soda, etc.) the presence of the sugar in this segment of intestine will create a reaction called dumping syndrome that affects the whole body.
An episode of dumping shows up as palpitations (heart racing), a sweaty and clammy feeling, cramping abdominal pain, diarrhea, and then a feeling of weakness during which the person simply must lay down for an hour or so until it passes. Dumping syndrome is not dangerous, but it feels awful.
Recovery
Most people typically stay in the hospital for a few days or less after gastric bypass surgery. Some may need to stay 4 to 5 days. Your doctor will approve your discharge to home once you can move without too much discomfort; eat liquid and/or pureed food without vomiting; and no longer require pain medication given by injection.
You will remain on liquid or pureed food for several weeks after the surgery. Even after that time, you will feel full very quickly, sometimes only being able to take a few bites of solid food. This is because the new stomach pouch initially only holds a tablespoonful of food. The pouch eventually expands. However, it will hold no more than about one cup of thoroughly chewed food (a normal stomach can hold up to one quart).
Upon follow up, your doctor will determine if you need replacement of iron, calcium, vitamin B12, or other nutrients. Supplements, such as a multivitamin with minerals, will be prescribed to provide any nutrients that you may not be getting from your diet. This lack of nutrients can occur because you are eating less and because the food moves through your digestive system more quickly.
Once your diet begins to consist of more solid food, remember to chew each bite very slowly and thoroughly.
You will be instructed on eating small meals frequently throughout the day, rather than large meals that your stomach cannot accommodate.
Your new stomach probably won’t be able to handle both solid food and fluids at the same time. So, you should separate fluid and food intake by at least 30 minutes and only sip what you are drinking.
You won’t be able to tolerate large amounts of fat, alcohol, or sugar. You should reduce your fat intake, especially fast food meals, deep-fried foods, and high-fat foods, as well as high-sugar foods like cakes, cookies, and candy.
You can generally resume exercise 6 weeks after the operation. Even sooner than that, you will be able to take short walks at a comfortable pace, with the approval and guidance of your doctor. Exercise improves your metabolism, while both exercise and attending a group support can boost your self-esteem and help you stay motivated.
Duration of Results
In adults, Gastric Bypass Surgery results in significant and sustained weight loss, which, in turn, has reversed or reduced the severity of many obesity-related disorders.
Risks
Gastric Bypass Surgery carries all the usual risks of major surgery, including bleeding; infections; follow-up surgeries to correct complications or to remove excess skin; gallstones due to significant weight loss in a short amount of time; gastritis (inflammation of the lining of the stomach); vomiting from eating more than the stomach pouch can hold; Iron or Vitamin B12 deficiencies (if they occur) can lead to anemia; and calcium deficiency (if it occurs) can contribute to the development of early osteoporosis or other bone disorders. Follow up surgeries may be less likely if gastric bypass is performed with a laparoscope.
Cost
Gastric Bypass Surgery costs $25,000 or more, although insurers are slowly beginning to accept that this kind of weight loss surgery can deliver powerful medical benefits that will save them money in the long run, especially where convention weight loss remedies have consistently failed to reduce obesity.
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