Gastric Bypass Weight Loss Surgery Information
Gastric Bypass: What is it?
Roux-en-Y Gastric
Bypass (RGB)
Gastric bypass operations are more extensive than the Gastric Band procedure. There
are several varieties of bypass procedure.
With this procedure a small stomach pouch is created by stapling part of the stomach
together or vertical banding.
This limits how much food you can eat. Next, a Y-shaped section of the small intestine
is attached to the pouch to allow food to bypass the duodenum as well as the first
portion of the jejunum.
1) Small intestine is
connected to the
stomach pouch.
2) Unused portion.
The diagram on the right shows what effect a Biliopancreatic diversion has on the
stomach.
1) The small intestine is connected to the stomach pouch. 2) Here we show the removed
portion of stomach area. 3) The Pancreas.
Biliopancreatic diversion Gastric Bypass (BPD)
In this more complicated version, portions of the stomach are removed and the small
pouch that remains is connected directly to the final segment of the small intestine.This
means that most of the small intestine (duodenum and jejunum) is bypassed,
resulting in substantial reductions in calorie and nutrient absorption.
Gastric Bypass Surgery
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Frequently Asked Questions (FAQ)
We have listed here some of the more commonly asked questions from our patients
about the Gastric Bypass procedure.
Q: How long does a gastric-bypass take?
This depends on the experience of the surgeon and if it is being done as an open
or closed (keyhole) procedure. Open gastric bypass operations usually take 90-120
minutes, but laparoscopic bypasses may take up to twice as long to perform.
Q: How long will I be in hospital?
For open operations, most patients are discharged on the third or fourth post-operative
day. Patients who have the laparoscopic procedure can go home on the second or third
post-operative day.
Q: What are the benefits of gastric bypass?
For the seriously obese, the benefits of the gastric bypass procedure very much
outweigh the risks. In general:
75% of patients are expected to lose 75 to 80% of their excess body weight, most
of which is lost in the first two years following surgery.
Major improvements in risk factors for heart disease and cancer.
Around 70-80% of patients with hypertension will be off medication and cholesterol
levels will fall.
Most type II diabetics will be cured.
There will be major improvements in a whole range of weight-associated conditions.
These could include sleep apnoea, asthma, joint pain, arthritis, reflux, fatigue,
shortness of breath.
Patients report less depression, improved self-esteem and confidence along with
an overall increased sense of well-being.
Q: What are the risks of gastric bypass?
As with any surgery, there are operative and long-term complications and risks associated
with gastric bypass, including:
Bleeding (haemorrhage).
Complications due to anesthesia and medications.
Infections.
Pulmonary emboli (blood clots on the lung).
Deep vein thrombosis.
Dehiscence (wound breakdown).
Leaks from staple line.
Injury to the spleen.
Marginal ulcers.
However, in experienced hands the risks of the procedure nowadays are very small.
Most published reports show that the overall mortality rate for gastric bypass surgery
is less than 1%. It’s also important to note that not only does bypass result in
reduced absorption of calories, it may also reduce absorption of important vitamins
and minerals such as iron, vitamin B-12 and calcium. Deficiencies in these nutrients
can lead to many problems. Iron deficiency causes anemia and weakness and deficiencies
in calcium can cause osteoporosis. Lack of daily B-12 can lead to neurological problems.
This is why patients undergoing gastric bypass are recommended to take a daily vitamin
and mineral supplement. "Dumping syndrome," in which the consumption of sugar causes
abdominal cramping and diarrhoea, can also occur. Some people will also regain some
weight in subsequent years.
A word of caution
Although there is no doubt that surgery can be both life-transforming and life-saving,
the decision to go ahead with surgery is a serious one. Any general anaesthetic
involves a measure of risk and individuals with serious degrees of obesity are at
greater risk than their non-obese counterparts. You should ensure that the surgeon
you choose is experienced and that the full panoply of specialist advice is available
at the hospital you choose. The choice of surgeon is crucial. This is not a procedure
for the general surgeon. It should only be carried out by those who are specially
trained in the surgery of the upper abdomen (upper GI surgeons).
The need for long-term follow up
A final note of caution is to remember that surgery is not a cure for obesity. It
is not a magic bullet and will not guarantee results without complete dedication
by yourself and by your physician.
If you are going to be successful you will have to continue to work on the behaviours
which are important for anyone attempting to lose weight, including physical activity,
reducing portion sizes, avoiding energy-dense foods etc.
For this reason, you should ensure the hospital of your choice has available a structured,
long-term behavioural and lifestyle programme, with nutritional support, which you
should join immediately after surgery.
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