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Gastric Bypass

How Gastric Bypass Surgery Works

Weight loss surgery focuses on two basic principles to facilitate weight loss: to limit the amount of food eaten and to limit the amount of food absorbed by the body. A restrictive procedure is one that limits the amount of food intake. A mal-absorptive procedure is one that alters the digestion process, so that the food eaten is only partially digested and not completely absorbed by the body, being eliminated as waste and causing fewer calories to be absorbed. Among the weight loss surgery options, some are primarily restrictive, while some use a combined approach. Gastric bypass is a complex procedure performed under general anesthesia. The surgery is approximately one to four hours, followed by a 1 to 3 day stay in the hospital depending on the patient’s recovery.

Roux-en-Y surgical technique is more common and considered less complicated than other surgical techniques. This surgery can be performed in two different ways, traditionally and laparoscopically. The traditional Roux-en-Y-gastric bypass is performed through open surgery with one long incision in the middle of the belly. Laparoscopic Roux-en-Y is a gastric bypass that requires using tools inserted through small incisions in the belly. A laparoscopic tool is inserted, which offers a visual guide to the inside of the abdomen during the procedure. The laparoscopic Roux-en-Y produces less scarring and allows the patient to recover faster than the traditional Roux-en-Y-gastric bypass. However, the laparoscopic approach is still new, so long-term results have not been fully evaluated.

The first step of the surgery is creating a small stomach pouch by dividing the stomach into a large and small portion. During this part of the surgery, the small part of the stomach is then sewn or stapled together to make a small pouch about the size of a golf ball.

The remainder of the stomach is not removed, and instead is completely sewn or stapled shut and seperate from the stomach pouch. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch. The part of the jejunum that is brought up behind the colon and lower stomach pouch is called the "Roux limb".

The other end is then connected into the side of the Roux limb of the intestine creating the "Y" shape that gives the technique its name. After a roux-en-Y, food passes directly from the stomach into the jejunum, bypassing the duodenum, thus reducing food intake. Stomach stapling and gastric bypass are typically performed during the same surgery. Together, this surgery is called a "roux-en-Y gastric bypass."

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 also called "restrictive," since the new stomach size restricts food intake.

Advantages of Gastric Bypass Surgery

Gastric bypass surgery is performed as a life-saving measure to treat the disease of obesity. It helps an individual who is obese lose a significant amount of weight and maintain weight loss over a long period of time. As gastric bypass patients lose weight, many of the health problems related to obesity are either cured or improved, including type 2 diabetes, high blood pressure, and sleep apnea. Many gastric bypass patients are able to save money because they reduce their dependence on medications for these health conditions. Overall, gastric bypass surgery can help you enjoy a more active, healthier, and a longer life. While it is important to consider the risks associated with weight loss surgery, it is also very important to consider the serious health risks associated with morbid obesity.

Concerns and Risks of Gastric Bypass Surgery

Before selecting gastric bypass surgery you need to be well informed and aware of the health concerns and risks associated with having this type of procedure. Before undergoing surgery, you should consider the expected changes in your life after gastric bypass. Due to the mal-absorptive aspect or the lack of nutrients absorbed as a result of gastric bypass surgery, patients are required to take nutritional supplements for the rest of their lives and need regular testing to make sure they do not develop nutritional deficiencies.

The limited absorption of vitamin B-12 and iron can cause anemia, and the lack of calcium absorption can lead to osteoporosis and metabolic bone disease. Lack of the proper nutrients can also cause neurological problems. This is why nutritional deficiencies cause serious health problems and must not be ignored. Another health condition to be aware of is the development of gallstones, which can occur with rapid weight loss. Medication can be taken to dissolve gallstones after surgery if this is a problem. Surgical risks to be aware of are: stretching of the new stomach pouch, separating of the two stomach sections due to erosion of the staple line, and leakage of the stomach contents into the abdomen.