Gastric Bypass Surgery
Also known as the Roux-en-Y gastric bypass, gastric bypass surgery helps patients to lose a significant amount of weight by altering how food passes the stomach and intestines. Food is redirected so that it bypasses most of the stomach and the first section of the small intestine and flows directly into the middle section of the small intestine. This surgery employs malabsorptive and restrictive techniques that speed up weight loss through restricting the amount of food injected at any given moments and by so doing, the number of calories and nutrients are also limited.
Gastric bypass surgery has proven to be safe, reliable and an efficient way to aid healthy weight loss as well as alleviating common obesity-related comorbidities such as type II diabetes, sleep apnea, hypertension, high cholesterol, including soft tissue infection and venous stasis disease (a collection of blood in the lower extremities)
Gastric bypass surgery is performed laparoscopically, and during the procedure, the surgeon uses a surgical stapling device and removes about 75-80% of the stomach to create a new small sleeve or banana-shaped stomach about an ounce in size at the top of the stomach that can hold less food. This process consequently reduces the caloric intake and leads to weight loss. After creating the small pouch, the small intestine is then cut and connected to the pouch so that food bypasses the first portion of the small intestine and goes directly to the new lower stomach.
This bypass process is important because not only does it produce essential changes in the hunger-suppressing hormone ghrelin, it also restricts the amount of food a patient consumes as well as the number of calories and nutrients absorbed. A mini gastric bypass is considered an alternative to gastric bypass surgery and a relatively quick and simple operation to perform using an endoscopic stapler to divide the stomach into two parts, and a new, narrower stomach pouch that can hold much less food is formed.
The role of the remaining larger stomach, which does not come into contact with food, is to produce digestive juices that aid digestion. Recovery from mini bypass surgery is pretty fast, and even though it’s recommended that patients remain in the hospital for up to five days, they often recover from the procedure within 24 hours. Possible weight loss as a result of MGBP is similar to the Roux-en-Y procedure with a 30-40% expected weight loss the only difference is the surgery and recovery time is shorter compared to the normal gastric surgery plus the MGBP procedure is easily reversible.
What to expect before and after gastric bypass surgery
When obesity does not respond to healthy diets and copious amounts of regular exercise, gastric bypass surgery can be the only way to enhance the quality of your life. The first step would be to consult with a Bariatric surgeon who, among other things will advise you on the life changes that you must make and help you determine your surgery eligibility through various physical and health assessment. You may be considered for this life-changing procedure if you meet the following pre-operative requirements:
- You must be between the age of 18 and 65
- If your BMI is 40 or higher or 35+ and you have obesity-related comorbidity, such as type 2 diabetes, high blood pressure, severe sleep apnea, asthma, high cholesterol, etc.
- You must be willing to undergo a psychological assessment and to adhere to a strict diet and exercise guidelines
- You must meet various medical conditions because some health issues such as blood clots, liver disease, heart problems, kidney stones and nutritional deficiencies are known to increase the risks associated with having surgery or may be exasperated by surgery
- You are required to prove that you have tried to lose weight with diet and exercise have been unsuccessful
Once you have met and exceeded the above pre-operative requirements and are cleared for surgery, the amount of weight you lose will largely depend on several factors. Such factors include the success of the surgery, how well you adhere to a nutrition and exercise plan as well as your willingness to make positive lifestyle changes for a continued weight loss and keeping the weight off. While the actual weight loss with gastric surgery will differ between individuals, the average excess weight loss to be expected is between 65 and 70% of your excess weight, which can occur anywhere from six months to a year after surgery.
Diet and exercise
After surgery, you will be on a strict diet plan that will help get you used to consume small portions of food that your new stomach can handle and comfortably digest and allow your stomach to heal without being stretched by the different food groups. This diet follows a staged approach to help you ease back into eating solid foods as you recover.
- A day or two after surgery, you will drink clear liquids such as broth or water, followed by other fluids, such as skim, low-fat milk, strained soup, or sugar-free gelatin or popsicles during stage 1
- Phase two involves eating strained and pureed foods without any solid pieces of food in the mixture
- Phase three is the soft food stage where you can eat finely diced or ground meats, soft vegetables, and seedless, skinless fruits
- You can gradually introduce solid or regular foods about eight weeks after surgery or until your surgeon clears you to do so.
It is important to wait about 30 minutes after a meal to drink anything and to chew your foods thoroughly to avoid gastrointestinal discomfort. Focus on high-protein diets and take all your supplements as recommended.
Some complications associated with gastric bypass surgery, during and after the surgery include bowel obstruction, infection, dumping syndrome, gastrointestinal reflux or leakage, nausea, vomiting, excess skin, to mention a few. These and other complications may not occur, but when they do, consult your surgeon so that he or she can remedy the side effects as soon as possible.