Gastric Bypass Surgery

What Is Gastric Bypass Surgery?

A Gastric Bypass is a method of weight loss surgery that involves making your stomach smaller and your digestive system shorter. It works by creating a small stomach pouch and bypassing part of your small intestine to make your digestive system shorter so nothing is actually removed from your body. Reducing the size of the stomach means that you can only eat small meals and your body will absorb less food helping you to lose weight.

With a gastric bypass there are two key parts to the procedure. The first part is the creation of a small stomach pouch and the second part is the bypass.

The creation of a small stomach pouch: During this part of the surgery, the stomach is separated into a large portion, and a much smaller portion. The small part of the stomach is then sewn or stapled together to make a small pouch. Another name for this procedure is stomach stapling. The small stomach pouch can only hold a cup or so of food. With such a small stomach, people feel full quickly and eat less. This strategy is restrictive, since the new stomach size restricts food intake.

The bypass: In this part of the surgery, the new, small stomach pouch is detached from the first part of the small intestine (the duodenum). The surgeon then reconnects the stomach to a portion of intestine slightly further down (the jejunum). The term for this surgical technique is roux-en-Y. After a roux-en-Y, food passes directly from the stomach into the jejunum, bypassing the duodenum. This leads to reduced absorption of calories and nutrients. This weight loss method is malabsorptive. Stomach stapling and gastric bypass are normally carried out during the same surgery. Together, this surgery is called a "roux-en-Y gastric bypass." The roux-en-Y procedure accounts for about 80% of all weight loss surgery procedures.

In order to perform gastric bypass surgery the surgeon uses tools inserted through a small incisions made in the stomach. When this is not possible, gastric bypass can be open. This called a laparotomy. This involves a large incision in the middle of the stomach.

Your surgeon will make four to five small cuts on your upper abdomen. He or she will then use small instruments. A special telescope guides these instruments with a camera to perform the operation. A single cut, which is about 30cm long, is made on your upper abdomen to perform the operation. Afterwards, the skin cut is closed using stitches and staples.

The surgery usually takes one to three hours to perform.

Preparation for your Gastric Bypass Operation

  • You will have a consultation to discuss the procedure step by step.
  • If you are a smoker, you will have to stop because smoking increases your risk of getting a wound infection and it will also slow down your recovery.
  • You will be hospitalized for two to four days.
  • You will have to follow fasting instructions. Usually surgeons must not eat or drink for about six hours before a general anaesthetic. However, some anesthetists will allow you to have sporadic sips of water until two hours before the surgery.
  • You may need to follow strict diet rules before the procedure to ensure you a fit and healthy for surgery. Your surgeon will discuss this with you.
  • The nurse may check your heart rate, blood pressure and urine.

The surgeon may ask you to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine called heparin as well as, or instead of, stockings.

After the Gastric Bypass Operation

You will probably experience some discomfort after the procedure a good pain reliever is paracetamol or ibuprofen.

Complications of Gastric Bypass Surgery

Nearly 10% of people have complications after gastric bypass surgery. These are usually minor and include:

  • Wound infections
  • Digestive problems
  • Ulcers
  • Bleeding

Only 1% to 5% of people have serious or life-threatening complications after gastric bypass surgery, such as:

  • Blood clot
  • Heart attack
  • Leak in the surgical connections with the intestines
  • Serious infection or bleeding

The risk of complications is lower at centers that perform more than 100 weight loss surgeries per year. When performed by a highly experienced surgeon, deaths in the month following gastric bypass surgery are rare: about less than 1 in 200 people.

Gastric Bypass Surgery Recovery

After gastric bypass surgery, people typically stay in the hospital for two to three days and return to normal activity within two to three weeks.

Possible side effects:

  • Feeling sick from the usage of the general anaesthetic
  • Some temporary bruising, pain
  • Temporary swelling around the healing wounds
  • You may feel or be sick after eating if you over eat
  • If you eat an overabundance of sugary foods, you can get an unpleasant sensation, called "dumping", which may make you feel sick or faint, or give you diarrhea.
  • Infection: antibiotics are given during surgery to prevent infection. If an infection does not respond to antibiotics your band may have to be removed.
  • Gallstones: there is a risk you may develop gallstones if you lose weight quickly.
  • Damage to other organs in your abdomen - you may need further surgery to repair any damage.
  • Bowel leakage: The point where your intestine is re-joined to your stomach pouch could leak the first few days. You may need to back into surgery to repair this problem.
  • A blood clot that occurs in the vein of the leg.

What can you do to reduce any side effects?

  • You should drink plenty of fluids until the feelings have passed.
  • Reduce the amount of sugary foods you eat.
  • Your restricted diet may cause some shortage of nutrients so you may need to take multivitamin tablets.
  • Ensure you stick to your aftercare instructions.

Benefits of Gastric Bypass Operation

Weight loss after gastric bypass surgery is often dramatic. On average, patients lose 60% of their extra weight. For example, a 350-pound person who is 200 pounds overweight would lose about 120 pounds. In turn this will also help improve and in some cases eradicate other disease caused by weight gain such as type 2 diabetes.

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