Gastric Bypass Surgery

Gastric Bypass Surgery

Gastric bypass surgery is a type of bariatric surgery (weight loss surgery). It works by reducing hunger and by reducing the absorption of minerals and nutrients from food through the intestine. Gastric bypass is a serious, complicated procedure. Like lap band surgery, gastric bypass is used in cases where other weight loss efforts have failed. Gastric bypass and lap band procedures can have a dramatic impact on life, as they improve appearance and make it easier to move about. More importantly, they also can reduce the risk of serious health problems such as diabetes, circulation disorders, and heart disease. Like most complex medical procedures, gastric bypass surgery requires that general anesthesia be administered (the patient is asleep). The procedure typically lasts one to four hours, and the patient usually stays in the hospital for one to seven days following surgery. Two procedures are available, both of which use a bypass (see below): Roux-en-Y-gastric bypass (normal and laparoscopic) and biliopancreatic diversion bypass.

Roux-en-Y-Gastric Bypass

The more common of the two gastric bypass procedures, roux-en-Y-gastric bypass is less complex than biliopancreatic diversion bypass because it does not require that sections of the stomach be removed. In the traditional procedure a long incision is made, while the laparoscopic procedure uses multiple small incisions. In the latter, a laparoscope is inserted, allowing the doctor to see the inside of the abdomen. This procedure causes less scarring than the traditional roux-en-Y-gastric bypass procedure. It also has a shorter recovery time. However, no long-term studies have been conducted on the laparoscopic procedure, so the long-term success rate has yet to be determined.

Biliopancreatic Diversion Bypass

Biliopancreatic diversion bypass is more complicated and less commonly performed than the roux-en-Y-gastric bypass procedure. The surgeon begins by making a long incision. Next, sections of the stomach are removed and the bypass is attached to the distal ileum (part of the small intestine). Due to the complexity and the risks associated with biliopancreatic diversion bypass (the procedure can lead to nutritional deficiencies), it is not a commonly-used procedure.

Gastric Bypass

In all of the above procedures, a pouch is created to reduce the size of the stomach. The pouch is then connected to the middle section of the small intestine (jejunum), bypassing both the top section of the small intestine (duodenum) as well as the rest of the stomach. By reducing the size of the stomach and bypassing portions of the stomach and intestine, gastric bypass surgery reduces the urge to overeat (creates satiety) and the absorption of the nutrients and minerals from food. As a result, most gastric bypass patients experience significant weight loss following surgery.

Side Effects and Potential Complications

While the incidence is relatively rare, serious complications can arise from any surgery. For gastric bypass surgery, complications include bleeding, infection, and respiratory problems. Talk to your doctor about the risks associated with gastric bypass surgery prior to undergoing surgery.

Recovery Period and Beyond

Following surgery, most patients spend two or three days in the hospital (one or two days for the laparoscopic procedure). In addition, gastric bypass surgery patients must spend several weeks recovering at home before returning to everyday activities. The procedure causes abdominal swelling, and most patients experience soreness for several days. Medication is available to alleviate postoperative discomfort. All of the gastric bypass procedures leave a scar.

Following gastric bypass surgery, most patients receive a dietary plan from their doctor and are encouraged to exercise regularly. Other treatments, such as vitamin supplements and behavioral modification therapy, are also available.