 The Gastric Bypass
Laparoscopy
The Operation
How the Gastric Bypass Works
Results
The Risks
Laparoscopy
One of biggest advancements in the gastric bypass operation has been the technique used to enter into the abdomen – the laparoscopic approach. The laparoscopic approach has a number of advantages.
- Small incisions. Generally five tiny incisions are necessary. Four are about 1/4” long and one is 1” long. Smaller incisions result in a smaller chance of infection with a risk of developing a hernia at less than one percent.
- Faster. Average operating room times are close to one hour. Less time in the operating room means less anesthesia and anesthesia-related complications.
- Less pain. Patients, although sore in the first few hours, often need only Tylenol with Codeine the day after surgery. Many patients do not require any medications for pain by the time they go home.
- Faster recovery. Generally, patients are walking the day of surgery, discomfort is easily controlled, and patients are at lower risk to develop blood clots, pneumonia, bed sores or other complications resulting from prolonged immobility.
- Quicker return to work. Patients can often return to work in one week.
Read more about Laparoscopy and Minimally Invasive Surgery
The Operation
During the operation, the stomach is cut to form a small pouch (usually one ounce in size). The remaining stomach and first one to two feet of small intestine are bypassed. In the standard gastric bypass, the amount of intestine bypassed is not enough to create malabsorption of proteins and other macronutrients. However, the bypassed portion of intestine is especially adept at absorbing calcium and iron – thus, anemia and osteoporosis are the most common long-term complications of the gastric bypass and are easily prevented with lifelong mineral supplementation. Other clinically significant deficiencies have been identified such as thiamine and Vitamin B12. Lifelong followup with a bariatric program is mandatory to monitor and prevent nutritional complications. We recommend specific supplements to prevent these long-term complications. Learn more about vitamins and minerals.
The unused stomach survives well with no demonstrable long-term problems. In fact, the unused stomach produces important enzymes.
How the Gastric Bypass Works
The mechanism in which the gastric bypass works is complex. After surgery, patients often experience significant changes in their behavior. Most state that they do not get hungry frequently and that their hunger is fleeting. Patients often state that they enjoy healthy foods and lose many of their food cravings. Rarely do people feel deprived of foods. These complex behavioral changes are partially due to poorly understood alterations in the hormones and neural signals produced in the gastrointestinal (GI) tract that communicates with the hunger centers in the brain. The small size of the stomach pouch restricts the volume of food people eat. Thus, the decrease in hunger and the rapid feeling of fullness accounts for most of the weight loss after a gastric bypass.
Another mechanism of weight loss after the gastric bypass is called dumping syndrome. Dumping syndrome causes intolerance of sweets after surgery. Dumping may result in lightheadedness, flushing, heart palpitations, diarrhea and other symptoms immediately after eating desserts. Some people are extremely sensitive to sweets for the rest of their lives; other patients lose some or all of their sweet sensitivity over time. The exact mechanism of dumping syndrome not entirely understood.
Results
The gastric bypass (GBP) has been proven in numerous studies to have good long-term weight loss. Average weight loss often peaks at 18 to 24 months after surgery, but half of all the weight loss often occurs in the first six months. The gastric bypass, through multiple studies, has been shown to improve or cure diabetes, hypertension, arthritis, venous stasis disease, certain types of headaches, heartburn, sleep apnea and many other disorders. Click here to learn more. Most importantly, the gastric bypass has demonstrated significant improvements in quality of health and life expectancy.
Estimate how much weight you may lose after bariatric surgery.
Risks
There are significant risks to any major operation, including death. A frank discussion with your surgeon is important in understanding these risks.
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