Gastric Bypass Surgery is one of the several restrictive and malabsorptive surgeries used for weight loss for those that are considered morbidly obese. This type of surgery divides the stomach into two parts so that there is less room for food to remain in the stomach, thereby making sure that the patient is unable to eat very much. The surgery procedure requires significant recovery time, but that has been shown to be effective in helping many lose the weight necessary to create a healthy situation and maintain it.
Ultimately it changes the way a person’s stomach digests food and how it is passed throughout the body. Gastric Bypass is the most common type of weight loss surgery procedure performed on the morbidly or super obese. The U.S. National Institutes of Health reports there is no procedure or treatment option that is more effective than bariatric surgery.
Good candidates for Gastric Bypass have proven failed attempts at losing weight and have a BMI of over 40 or 35 with 1 or more comorbidities as a result of their obesity. This is typically a patient who is more than 100 pounds overweight. Many tests will be done before surgery in order to determine whether it is safe for the patient to have the procedure or not. The surgery is not recommended for patients 55 and older with Type II diabetes or high blood pressure.
The surgery is especially great for those with life-shortening medical conditions. Some of these include:
All of these conditions can shorten a person’s life and are considered weight-related health conditions or co-morbidities. With gastric bypass surgery, they will be able to improve or be completely resolved with weight loss.
Also, individuals who have trouble losing weight naturally remain a great candidate for this type of bariatric surgery. Doctors like to see that patients have tried for 1-2 years to lose weight on their own along with regular exercise. If the patient still cannot manage to lose weight, then gastric bypass (or another type of weight loss surgery) may be right for them. It’s important to understand that gastric bypass is not a quick fix for weight loss as it involves a commitment to eating right and remaining active for a lifetime.
Not only will patients experience extreme weight loss, but also will see improvement or resolution in comorbidities. Some of these medical conditions include obstructive sleep apnea, high cholesterol, high blood pressure, Type II Diabetes, and arthritis. While gastric bypass surgery is considered a permanent solution, it can be reversible if a blockage or leakage occurs.
Gastric Bypass surgery can be laparoscopic in nature or by open surgery means. This involves a small camera that goes into the abdomen, which helps the surgeon to perform the procedure. The surgery is more technical in nature than the lap band surgery or the gastric sleeve surgery. The surgery not only reduces the size of the stomach, but it also creates a direct passage between the lower stomach (newly created stomach) and the lower intestines allowing the food to go straight through with minimal absorption of calories along the way. In this way, the surgery works on two levels as a restrictive surgery reducing the stomach size and a malabsorptive level, reducing the calorie intake of the body. The surgery can take two to three hours.
There are several types of gastric bypass surgery. These types include Biliopancreatic diversion with duodenal switch, Laparoscopic adjustable gastric banding, Roux-en-y, sleeve gastrectomy, and vertical banded gastroplasty. Each type depends on the type of patient, their current health and their overall weight loss goals. The patient’s doctor will determine the best option for them based on their body mass index and their eating habits.
The non-laparoscopy version of Gastric bypass surgery divides the patient’s stomach into a small and large section. The top section is the pouch where the food will go when they eat. This pouch is only the size of a walnut and can hold about one ounce of food. The bypass is performed by connecting this small section of the patient’s small intestine to a small hole found in the pouch. This will cause the patient’s body to absorb a small number of calories than they are used to and encouraged extreme weight loss.
The weight loss expected for most patients with a Gastric Bypass surgery is between 65% and 80% overall. This typically works with a 50% weight loss within the first year of the surgery and a total of 80% by the third year after the surgery. This varies based on the individual and their lifestyle changes.
Patients can expect to lose from 50-80% of their excess weight before surgery. Excess weight is determined by subtracting one’s ideal weight from their current weight. Typically gastric bypass patients lose the most weight than any other weight loss surgery (up to 77%) within one to two years after surgery. They also maintain the most weight loss over a longer period of time following their surgical procedure.
The cost of gastric bypass will depend on the surgeon, the geographical region a patient lives and where the surgery will be performed. Typically insurance companies do cover this procedure as it is deemed a medical necessity for many patients. You will need to go through your insurance company’s specific requirements to be approved for surgery. For those without insurance, paying all cash will lower the overall price of the procedure. Other financing plans are offered for those with no liquid funds and no coverage.
There are both long-term and short-term side effects for gastric bypass surgery. One’s overall risk will depend on whether or not they follow their post-op instructions closely, their overall health and in the opening that lies between their intestines and their stomach and if it becomes narrower than needed. Follow up care is imperative to help reduce the risk of surgery-related risks or complications from occurring.
Some of the most common risks include port or wound infection, incisional hernia, acute stomach obstruction, intestinal leak, nausea and vomiting, dehydration and nutritional or vitamin deficiencies. Some other more rare risks or complications include lung problems, excessive bleeding, dumping syndrome, low blood sugar, ulcers, gallstones, stomach perforation, bowel obstruction, and malnutrition.
Some patients will have a catheter installed between their nose and stomach. After a few days, a tube will be used to drain all of the fluid from the stomach. Some patients may also have a catheter in their bladder. By the time patients are released, they must keep solid foods down and move without any pain. They will have to walk daily and will have to wear support stockings to help prevent blood clots from forming in the legs.
Patients will follow up with their surgeon a few days after being discharged from the hospital. They will have monthly appointments for the first year following surgery then follow-up visits will vary depending on their overall health after that time period.
There are four stages to the gastric bypass post-op diet. The first is liquids, which will occur for the first few days following surgery. Once a patient can handle liquids they will be able to have pureed foods for two to four weeks. After the doctor has determined that the body can handle this food well, then soft, solid foods are introduced which are generally eaten for about eight weeks. After those two months, solid foods are introduced slowly. Patients should avoid nuts, dried fruit, seeds, carbonated beverages, popcorn, granola, breads, tough meat with gristle and stringy vegetables.
Patients will need to take a calcium supplement, Vitamin D, iron, Vitamin B12 and a multivitamin daily because of the restrictive surgery method.