Synonyms: Stomach Stapling, Roux-En-Y, Bariatric Surgery, Weight Loss Surgery, Gastrointestinal Surgery for Obesity, Traditional Gastric Bypass, Open Roux-En-Y
What is Gastric Bypass?
Gastric Bypass is considered to be the 'Gold Standard' for weight loss program in morbidly obese people. Gastric Bypass offers a successful combination of weight loss without significant nutritional deficiency.
The Gastric Bypass operation restricts food intake and reduces the feeling of hunger. As a result, you experience an early sense of 'fullness' and satisfaction just after eating a few bites of food.
Where can I get a Gastric Bypass?
Cost of procedure performed in the US: $30,000.
All prices are in US dollars and include the cost of the procedure and minimum hospital stay. Estimates and minimum hospital stay will vary depending upon individual needs and requirements.
How does the Gastric Bypass work?
Gastric Bypass allows you to lose weight in 3 ways:
- The volume of food that you can consume at one time is restricted. Since the stomach has been divided into a small pouch by the Gastric Bypass operation, you feel full after eating a small amount of food.
- There is modification of your eating habits. After Gastric Bypass procedure, you cannot tolerate refined sugars and fats, so you tend to avoid foods that contain them.
- The surface area of the stomach where food can be absorbed is reduced by Gastric Bypass operation.
Who is an ideal candidate for Gastric Bypass?
If you are 100 lbs. or more above the ideal weight for your age and height, if you have other health problems associated with being over weight like sleep apnea, hypertension, hyperventilation, cardiovascular diseases, diabetes, if you have tried and failed all other non-surgical methods of weight loss like dieting, exercising etc, if you have a BMI (Body Mass Index) of 40 or above, then you are an ideal candidate for Gastric Bypass.
What are the different types of Gastric Bypass operation?
- Traditional Gastric Bypass or Open Roux-En-Y - In this kind of operation, the stomach is divided and a very small pouch is created which is connected to the small intestine, allowing the lower part of the stomach to be bypassed. Gastric Bypass operation allows you to eat all kinds of foods but in small quantities. In traditional Gastric Bypass, a larger incision is made that extends from the lower part of your rib cage up to your navel.
- Laparoscopic Gastric Bypass - The smaller stomach pouch is created in this surgery. This small pouch can now hold a very small amount of food and a feeling of fullness is attained very quickly, even after eating less than one ounce, thus restricting your food intake considerably. As a result the body burns the fat for everyday energy. This surgery also changes the way your food is absorbed. Laparoscopic Gastric Bypass is performed with the help of a laparoscope and is considered to be a minimally invasive procedure.
- Fobi procedure - In this procedure for Gastric Bypass, a very small pouch is created that is connected to the small intestine. This kind of procedure restricts the amount of food that can be eaten and at the same time also inhibits absorption of nutrients.
- Distal Gastric Bypass - In this procedure, the Y - connection is made further down to reduce the length of small intestine available for absorption.
- Biliopancreatic Diversion - In this type of Gastric Bypass, a part of the stomach is removed leaving a small pouch with a 200 - 250 cc capacity and the small intestine is shortened to about 250 cm. This re-arrangement is done to divert the digestive juices so that starches and fats are not absorbed. This diversion of digestive juices does not effect the absorption of protein and sugars.
- Jejuno-ileal Gastric Bypass - In this procedure, a very small segment of intestine is connected to the stomach pouch which results in significant malabsorption of nutrients.
- BilioPancreatic Diversion with Duodenal Switch - In this procedure of Gastric Bypass, the biliopancreatic digestive juices are available only to a very small length of small intestine to absorb fat and starches. This re-arrangement allows you to eat all sorts of foods except for foods containing large amounts of fats and starches which will need to be restricted.
- Gastric Banding (Lap. Band) - In this operation, an adjustable band is placed on the stomach giving it an hour-glass appearance, making a small pouch with a narrow outlet.
This special device is made of implantable silicone rubber, contains an adjustable balloon, which allows your surgeon to adjust the function of the band, without re-operation.
- Gastric Partitioning - This Gastric Bypass operation is performed very commonly worldwide. In this kind of Gastric Bypass operation, the stomach is stapled and reduced into a very small pouch that is is restricted at it's outlet by a mesh which delays it's emptying time, thus giving a feeling of fullness after eating just a few bites of food.
- Adjustable Banded Gastroplasty (ABG) - In this procedure of Gastric Bypass, an adjustable band is placed on the stomach without any cutting or stapling of any organs.
What does Gastric Bypass involve?
Traditional Gastric Bypass procedure is performed in people who are extremely obese. Gastric Bypass is considered a major surgery. In the open or traditional Gastric Bypass procedure, an incision about eight inches long is made to expose the stomach. The incision runs from the lower part of your rib cage up to your navel. The stomach is partitioned into a small pouch to which small intestine is attached. About 18 inches of small intestine below the stomach is cut and re-arranged to maintain the flow of digestive juices. The larger lower side of the stomach pouch is bypassed and the food enters the small intestine within minutes of starting a meal. The Gastric Bypass surgery is performed under general anesthesia, takes about 2 hours and would require you to be hospitalized for a few days.
What does the pre-operative preparation for Gastric Bypass involve?
Try to lose as much weight as possible before your Gastric Bypass surgery. Increase your physical activity and make positive lifestyle changes that you will be required to make after Gastric Bypass surgery. During your pre-operative check up, make sure that you inform your physician about your health conditions, all the prescription and non-prescription medications that you take (including vitamin, mineral and herbal supplements). Your surgeon will instruct you to be on a liquid diet
like water, clear juice, tea, coffee, popsicles, gelatin and broth for 2 days before the surgery. If you have a tendency to be constipated, take a laxative to cleanse your bowel before the surgery. Do not eat or drink any thing at least 10 - 12 hours before Gastric Bypass surgery.
What is the recovery period like following the Gastric Bypass?
The recovery period following Gastric Bypass is quite smooth. Your diet in the first week will consist of clear liquids like water, tea, strained soup and juices. After about two weeks of Gastric Bypass you can eat soft foods, such as eggs, cream of wheat, mashed potatoes, applesauce, yogurt and cottage cheese, but avoid rice and bread for some time. Over time you will be able to set a meal plan for yourself and get used to keeping to it. Your portions will be extremely small and you will be able to eat foods from one food group at any given time. Your tolerance for different foods will also increase a few months after Gastric Bypass. You may experience
nausea and vomiting, this may happen after eating too fast, drinking liquids while eating, not chewing enough or eating more than the stomach pouch can comfortably hold. Make sure you chew your food thoroughly and do not overeat after Gastric Bypass surgery.
What is the outcome of Gastric Bypass?
Gastric Bypass surgery has a good outcome. Most people who undergo Gastric Bypass can lose up to 40% of their weight. Gastric Bypass is a surgery of choice for those people who are overweight by more than a 100 lbs. Gastric Bypass is a very important weight reduction surgery which may improve medical problems caused or made worse by obesity such as cardiovascular disease, sleep apnea, hyperventilation, diabetes and high blood pressure. The most or equally important outcome is improvement of self-image and physical activity following Gastric Bypass surgery.
B . R . A . N . D . of Gastric Bypass
Benefits of Gastric Bypass
- There is of course dramatic weight loss following Gastric Bypass. There is also improvement of obesity associated health problems like hypertension, cardiovascular diseases, diabetes, hyperventilation, sleep apnea etc following Gastric Bypass surgery. Of course the biggest prize of this weight loss surgery is improved self image and self esteem. There is also improvement of physical activity. Gastric Bypass ensures a consistent loss of weight over a prolonged period of time.
Risks of Gastric Bypass
- Excessive bleeding
- Rupture of the staple / suture line
- Stomach Ulcers
- Nutritional deficiencies
- Anemia - Iron and vitamin B12 deficiency
- Osteoporosis - Calcium
- Abdominal hernias
- Dumping syndrome
- Narrowing of the opening between the stomach and small intestine.
Alternatives to Gastric Bypass
- Laparoscopic Gastric Bypass - Also known as 'keyhole surgery', Laparoscopic Gastric Bypass is performed to create a small pouch out of a portion of stomach. Laparoscopic Gastric Bypass surgery helps you to fight the problem of obesity. You can lose about 75% of your excess weight and maintain the weight loss for years after this surgery. This is a minimally invasive procedure and is performed with the help of a Laparoscope.
- Lap-Band Procedure – In this procedure, a band is placed about one centimeter below the gastro-esophageal junction. This creates a smaller stomach pouch. A reservoir is placed under the skin to connect to the band and allow for the opening to be tightened or loosened (to accommodate for increased demand of food consumption such as during pregnancy). This is a minimally invasive (laparoscopic) procedure, hospital stay is less than 24 hours and there are fewer post-operative complications
- Vertical banded gastro-plasty – This procedure restricts and decreases food intake and does not interfere with the normal digestive process
- Bilio-pancreatic diversion or Bilio-pancreatic diversion with duodenal switch - This operation restricts your food intake and also the amount of calories and nutrients your body can absorb.
Now or Never
- Gastric Bypass surgery commonly referred to as stomach stapling, is an excellent option for you if you are severely obese and cannot lose weight by traditional means or if you suffer from serious obesity-related health problems. Timely Gastric Bypass surgery accompanied by change in eating behavior and regular exercise can decrease your chances of developing serious and life threatening health problems.
Decision to have Gastric Bypass
- Following Gastric Bypass, most people start to lose weight immediately. However, there are some long term problems due to malabsorption of nutrients like iron, vitamin B12 and calcium deficiency which can be prevented if you work closely with a dietitian and follow their advice.
Your Questions Answered on Gastric Bypass
B.R.A.N.D. of Gastric Bypass
Gastric Surgery References