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 The following surgery is performed using a laproscope, which is inserted through a small incision on your abdomen. You will have 6 incisions on your abdomen. The surgery that is performed is based on your body mass index (BMI) and on your eating habits. Body mass index is a formula for determining obesity. It is calculated by dividing a person's weight in kilograms by the square of the person's height in meters (kg/m2).
A gastric bypass is a restrictive surgery where a small pouch is made at the upper portion of the stomach, which can hold only 1-2 tablespoons in volume. This means you will feel full with only a small amount of food and your intake is restricted. This pouch is connected to a piece of small bowel through a Y -shaped connection, giving it the name Roux-en Y gastric bypass.
Gastric bypass surgery may take several hours to complete, and patients often recover in the hospital for 1 to 2 days afterward, although this will depend on the their specific needs. A liquid diet supplemented with pureed foods must be followed for several weeks after the procedure. Potential complications include:
- Bleeding
- Infections
- Gallstones
- Gastritis (inflammation of the stomach lining)
- Vomiting
- Iron, calcium, or vitamin B-12 deficiency
- "Dumping syndrome" - A condition where food empties too quickly into the small intestine, resulting in nausea, cramping, vomiting, diarrhea, bloated feeling, dizziness, sweating.
- Further surgeries to correct complications or tighten loose skin
After surgery, the patient's stomach can hold about 1-2 tablespoons of food. This will expand over time but will not exceed one cup. (A normal stomach holds one quart.) Because stomach size is substantially and permanently reduced, patients are limited in the amount of food they can eat in a single meal, and do not suffer from constant hunger. Smaller meals eaten throughout the day are recommended over less frequent, larger meals.
Although the Y-connection allows pancreatic fluid and bile to aid in absorption of nutrients, bypass of the large intestine from the digestive process may result in insufficient absorption of vitamins and minerals along with the desired reduction in fat absorption. Regular meetings with the surgeon and with a dietician will be scheduled before and after surgery to establish a diet and exercise plan and determine whether nutritional supplements are necessary. These appointments will take place several times during the first year following surgery and less frequently afterward.
Gastric bypass surgery is not easy. Patients who undergo the procedure must be willing to make lifestyle changes to achieve and maintain weight loss and prevent complications from the surgery. But with determination, good nutrition and regular exercise, the results can be dramatic: Most patients lose about 1-2 pounds per week and reach a stable weight 18 to 24 months after surgery. Weight loss is typically fastest immediately after surgery. Patients often enjoy relief from weight-related illnesses such as sleep apnea, type 2 diabetes, high blood pressure, heartburn and incontinence.
Candidates for gastric bypass surgery typically have a Body Mass Index or BMI of 40 or more, or a BMI of 35 with a serious illness that can be improved with weight loss (a normal BMI is between 18.5 and 25). Other factors are taken into consideration, including the patient's physical and mental health and ability to follow a strict diet and exercise program. Patients interested in this procedure should schedule a consultation with their physician.
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