Gastric Bypass Surgery

What is Gastric bypass surgery?

Gastric bypass surgery is a type of weight-loss surgery. It involves making a small pouch from the stomach and connecting it directly to the small intestine. The swallowed food will go into this pouch and then directly into the small intestine, thus bypassing a large part of the stomach and the major segment of the small intestine.

This procedure is one of the most commonly performed types of bariatric surgery. Gastric bypass is recommended when the patient cannot respond to all types of diet and exercises or when their excess weight becomes the cause of severe health problems.

Types of Gastric Bypass Surgery

• Roux-en-Y (roo-en-wy) Gastric Bypass: This is the most common procedural technique of gastric bypass. Roux-en-Y (roo-en-wy) Gastric Bypass is typically irreversible. It reduces the amount of food an individual can eat at a time and decreases the absorption of nutrients. The surgery involves cutting across the top part of the stomach and sealing it off from the rest of the stomach. The final pouch created is about the size of a walnut. It is aimed at allowing the stomach to hold only about one ounce of food. Usually, the stomach is capable of holding about three pints of food. After that, the surgeon will cut the small intestine and sew a part of it directly into the pouch. The food is supposed to reach this small pouch and then directly into the small intestine, sewn to it.
• Sleeve Gastrectomy: The procedure involves the removal of around 80% of the stomach to leave a long pouch similar to a tube. The smaller stomach is created to hold a small amount of food. This newly created stomach size will produce less 'ghrelin' (appetite-regulating hormone) to reduce the desire to eat. The procedure will lead to significant weight loss and no redirecting of the intestines. Sleeve gastrectomy also involves a shorter hospital stay than most other procedures.

• Biliopancreatic Diversion with Duodenal Switch: The surgery is conducted in two parts. The first step of this surgery involves a procedure similar to a sleeve gastrectomy. The second surgery step involves a duodenal switch and biliopancreatic diversion (a process that joins the end portion of the intestine to the duodenum near the stomach). This bypasses the major portion of the intestine.

  The result of surgery restricts the amount of food one can eat and decreases the absorption of nutrients too. This surgery is highly effective but also has a greater risk such as malnutrition and vitamin deficiencies.

Advantages of Laparoscopic vs. Open Surgery

• Shorter hospital stay and quicker recovery
• Less pain
• Smaller scars
• Reduced risk of getting a hernia or infection

Success Rate of Gastric Bypass Surgery

As a general rule, the success rate of this surgery can be defined as achieving a 50% weight loss or more excess body weight and maintaining it for at least five years. As per clinical studies, most patients lose weight quickly and continue doing so following surgery (up to 18-24 months after the procedure). Patients may lose 30-50% of their excess weight during the initial six months. Around 77% of excess weight is shed in the first 12 months after surgery.

According to many published studies, patients could maintain 50 to 60% of excess weight loss for 10-14 years after surgery. The body mass index of an individual plays a crucial role in weight loss after surgery. Patients with a higher initial BMI tend to lose more total weight, whereas patients with a lower initial BMI will lose a more significant percentage of their excess weight. They can achieve their ideal body weight (IBW) faster. Type 2 diabetes patients show less overall excess weight loss than those without Type 2 diabetes.

Risks associated with Gastric Bypass Surgery

Constipation is a common side effect of weight loss surgery. Speaking to your doctor will help you find ways to deal with constipation after Gastric Bypass Surgery.

Dumping syndrome may be caused due to eating high-sugar meals after weight loss surgery causing side effects such as nausea, vomiting, and weakness.

Gallstones are also a common risk. Around 50% of patients will develop gallstones after gastric bypass surgery. These are harmless and cause side effects such as abdominal pain, nausea, and vomiting.

• Wound Infections
• Bleeding in stool
• Blood clots
• Leaks at the newly joined connections
• Quality of life after undergoing surgery

Gastric Bypass Surgery can lead to a dramatic improvement in quality of life. Commitment to good nutrition and staying active will help you maintain results.

Before, During, and After Gastric Bypass Surgery

Before Surgery: First, a patient needs to qualify for Bariatric surgery. Patients must be educated on the risks and benefits of the surgery. Usually, adults eligible for this surgery are 100lbs over weight or have a body mass index (BMI) over 35. Those with a BMI between 30 and 35 are also eligible for surgery. Individuals with health risks due to being overweight can also qualify for surgery. Gastric bypass surgery is suggested to individuals who have tried everything (diet, lifestyle changes) but have failed to lose weight. Before surgery, the patient will be given a special diet to follow. This is important to reduce the risk of complications during the surgery.

During Bypass Surgery: The patient is given general anesthesia, meaning he/she will be asleep for the surgery. The surgeon manipulates the stomach's top portion into a small gastric pouch. The surgeon will cut a loop of the small intestine and connect an end of the loop to the gastric pouch creating an anastomosis. The other end of the small intestine loop is then reconnected to the small intestine (second) anastomosis. The food is then transmitted to an area further down in the digestive system. It bypasses the stomach, which makes the body absorb fewer calories. The patient will feel full much faster after eating.

After the Surgery: A dietician will customize general diet guidelines for you, which include several weekly phases. This plan is aimed at helping you recover, meet the requirements of a new smaller stomach, and develop healthier eating habits. Your physician will also suggest dietary restrictions after surgery. Initially, patients are allowed to drink a few ounces of clear liquids. It is crucial to help the stomach heal without being stretched out by the food. Spicy seasonings, fruits, and vegetables with lots of seeds are not allowed. Gradually, the doctor will allow soft, semi-solid, and then solid foods into your diet.

Recovery: The patient is expected to spend a day recovering in the hospital. Once discharged from the hospital, the patient will need a few weeks to recover at home before returning to work. It is important to avoid strenuous activity for up to 6 weeks. Most patients may require up to 12 weeks before resuming a normal diet.

Recovery

Gastric bypass surgery is performed laparoscopic, which means it can be performed by making small incisions. The most significant advantage is that the procedure requires a shorter recovery time than other procedures. Most patients are required to stay in the hospital for 2-3 days. They can return to normal activities within 3 to 5 weeks after the procedure.

The healing can take longer in the rare case that the surgery must be "open" (involving a larger incision). Usually, people lose around 60% of their extra weight after gastric bypass surgery.

Why choose our Surgeons and Physicians?

We are committed to helping our patients achieve their weight loss goals. Our multi-disciplinary team of experts will guide you on various steps involved in the procedure, such as obesity screening, counseling, and a planned program with several follow-ups.

We offer dedicated care by a team of highly skilled and experienced board-certified physiotherapists, dieticians, gastroenterologists, cardiologists, bariatric surgeons, and clinical psychologists who will care for our patients and help them achieve their weight loss goals safely.

We also offer personalized treatment to patients based on their condition and weight management goals.

Frequently Asked Questions