Gastric bypass is a type of weight loss surgery that works by making your stomach smaller and removing part of your bowel to make your digestive system shorter.
The procedure This surgery involves creating a small 20 cubic centimetre (or thumb-sized) pouch from the upper part of the stomach. A section of the small intestine is then removed before it is re-connected to the pouch so that food bypasses part of your digestive system. As a result, weight loss is accomplished both by restriction of food and because nutrients are less easily absorbed by the body.
Many people report diminished appetite after this type of surgery, known as a Roux-en-Y (RNY) gastric bypass, as well as a change in the taste of food. This is so because the digestive enzymes normally produced in the stomach, liver, pancreas and upper small intestine continue to be made, but do not contact the food that has been ingested until further down the intestine.
Gastric bypass surgery is usually performed laparoscopically (keyhole), the advantages of which are that recovery is faster and cosmetically the results are better. Some long-term problems, such as incisional hernias, also occur less frequently. Sometimes previous abdominal surgeries make the laparoscopic technique difficult or impossible, because of adhesions (scarring), so an open procedure may be necessary.
Recovery The Roux-en-Y gastric bypass routinely necessitates a stay of three to five days in hospital.
The risks
Following RNY surgery, patients are at risk of developing anaemia because of poor absorption of iron and vitamin B12. Therefore, dietary supplementation of these nutrients is required. Poor absorption of calcium may also occur. Thus, calcium supplements must be taken post-operatively and exercises are important to prevent bone demineralisation.
Since the staples at the top of the stomach completely block off the lower portion of the stomach and the upper small intestine, there is no easy way to evaluate these portions of the gastro-intestinal tract should a problem, such as ulcer, bile duct stones or cancer, arise at a future time. In fact, although this could be a very real problem, it seldom becomes an issue.
Ingestion of concentrated sugar is also essentially prohibited because doing so results in "dumping". Dumping is a group of unpleasant symptoms that resembles food poisoning (nausea, vomiting, diarrhoea, abdominal cramps, flushing/sweating and palpitations) that occurs when simple sugars enter the small intestine in high concentration.
The benefits Weight loss commonly reaches 70% of a person's excess body weight. However, as in all weight loss surgery, the amount of weight loss is not guaranteed and depends not only upon the surgery, but also upon what you do afterwards. If you adhere to the diet, and if exercise becomes a part of your regular routine, a substantial weight loss usually results.
After losing this amount of weight, patients usually feel physically and mentally better. Pre-operative problems such as diabetes, hypertension, stress incontinence, back pain, knee pain, heel pain, sleep apnoea and other complications of obesity are usually either improved or eliminated altogether.
Remember surgery is not a cure for obesity; it is merely a tool.
Next steps A free consultation is available with our Consultant Bariatric Surgeon. This is an opportunity to discuss all the options, your suitability for treatment and the procedure itself. To make an appointment please call us on 020 8936 1201.
