Gastric Bypass Surgery
Gastric bypass surgery is a popular weight loss procedure for morbidly obese people unable to lose weight with diet and exercise alone. The procedure offers a way to lose a significant amount of weight, but is only successful if lifestyle and diet modifications are made in the months and years following surgery.
Roux-en-Y Bypass
Roux-en-Y gastric bypass (RGB) is the most common type of bypass surgery. During this open surgical procedure, a small, walnut-sized pouch is created at the top of the stomach and held in place by staples or vertical banding. Because the stomach pouch is so small, you will only be able to eat small amounts at a time. After the pouch is made, your surgeon will attach part of the small intestine directly to the pouch, allowing the food to bypass the rest of the stomach and the first part of the small intestine, which will reduce your ability to absorb calories. You will probably need to stay in the hospital three to five days following surgery.
RGB can also be done laparoscopically through small incisions in the abdomen. A flexible tube with a camera attached is inserted through one of the openings, allowing the doctor to see the stomach and perform the surgery. If you have laparoscopic RGB, you will have a shorter recovery period and hospital stay.
Extensive Gastric Bypass
Extensive gastric bypass is a more complicated form of the surgery in which the lower part of the stomach is removed. The remaining part of the stomach is then attached to the small intestine. This procedure is not used very often because it is more likely to cause nutritional deficiencies.
Risks
Over time, the stomach pouch can stretch and can even eventually reach its pre-surgery size. If a vertical band is used to form the pouch, there is a possibility that the band can disintegrate over time, causing the stomach to revert to its original size. Staples can also break down over time. Nutritional deficiencies or leaking of stomach contents in the abdomen can occur in some cases. Patients are usually advised to take nutritional supplements to prevent deficiencies.
In some patients, dumping syndrome is problem. This occurs when the contents of the stomach move through the small intestine too quickly causing weakness, nausea, faintness, diarrhea and sweating. Following gastric bypass surgery, you may also develop a hernia at the incision, gallstones, intolerance to some foods, blood clots in the legs or kidney stones. As with any major surgery, complications can occur that result in death.
Benefits
You can expect to lose approximately 70 percent of your excess weight in the first two years following surgery if you follow your doctor's recommendations for diet and exercise. When you reach a healthy weight, you will reduce your risk of developing heart disease, high blood pressure, high cholesterol and Type 2 diabetes. Losing weight may provide some relief of symptoms associated with being overweight, such as sleep apnea, shortness of breath, urinary problems and heartburn. Without the extra weight, you may feel less joint and back pain. Some people with high blood pressure may be able to eventually discontinue medication after weight loss.
Life After Surgery
After surgery, you will have to carefully monitor what you eat and how much you eat. A few days after surgery, you will be started on a liquid diet, followed by the introduction of pureed and soft foods. After about three months, you will be able to resume eating regular food, although your meals will be much smaller than usual. If you eat too much or eat your meal too quickly, you many vomit or feel pain under the breastbone. Doctors recommend that you eat high protein foods and eat and drink slowly to prevent dumping syndrome. Chewing food thoroughly is important because large pieces of food can block the opening between the stomach and the small intestine. You will need to limit high fat or high sugar foods to prevent weight gain, avoid snacking, get regular exercise and take vitamins.
