Gastric Bypass Surgery

ExtendedRYGBP72Roux-en-Y Gastric Bypass is one of the most frequently performed procedures for morbid obesity in the U.S. The gastric bypass solution uses both a restrictive and a malabsorptive surgery technique. It restricts food intake and the amount of calories and nutrients the body absorbs. In addition to creating a smaller stomach pouch, the surgery changes the body’s normal digestive process. As a result, food bypasses a large part of the stomach and most of the small intestine.

Gastric bypass surgery studies have shown that gastric bypass patients typically lost 61.6% of their excess weight after bariatric surgery. Many health problems (back pain, sleep apnea, high blood pressure, type two diabetes, and depression) improve or are resolved following surgery.

The surgeon first creates a small stomach pouch and then attaches a section of the small intestine directly to the pouch. This allows food to bypass a portion of the small intestine, which absorbs calories and nutrients. Having a smaller stomach pouch causes you to feel full sooner and eat less food; bypassing a portion of the small intestine means your body absorbs fewer calories. Gastric bypass patients report an early sense of fullness and satisfaction that reduces the desire to eat.

One study found that following laparoscopic gastric bypass, patients were able to leave the hospital after two days and return to work after 21 days.

Advantages

  • Limits the amount of food that can be eaten at a meal and reduces the desire to eat.
  • Average excess weight loss is generally higher than with gastric banding or sleeve gastrectomy.
  • No postoperative adjustments are required.
  • An analysis of clinic studies reported an average excess weight loss of 61.6% in 4,204 patients.
  • Shown to help resolve type two diabetes, high blood pressure, and obstructive sleep apnea, and to help improve high cholesterol.
  • In a study of 608 gastric bypass patients, 553 maintained contact for 14 years; the study reported that significant weight loss was maintained at 14 years.

Risks

  • Because the duodenum is bypassed, poor absorption or iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia. Women should be aware of the potential for heightened bone calcium loss.
  • Bypassing the duodenum has caused metabolic bone disease in some patients, resulting bone pain, loss of height, humped back,and fractures of the ribs and bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
  • Chronic anemia due to vitamin B12 deficiency can occur. This can usually be managed with vitamin B12 pills or injections.
  • When removing or bypassing the pylorus, a condition known as dumping syndrome can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness, and on occasion diarrhea after eating.
  • In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15 to 30 cc.
  • Rerouting of bile, pancreatic, and other digestive juices beyond the stomach can cause intestinal irritation and ulcers.
  • The lower stomach pouch and segments of the small intestine cannot be easily visualized using x-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.

The above are in addition to the general risks of surgery. Talk with the surgeon about the possible surgical risks.

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