Gastric Bypass Surgery

Consumer Guide to Gastric Bypass Advantages

Gastric Bypass Surgery

Weight loss surgery is considered a last resort treatment for someone who is morbidly obese and has tried for years to lose weight with traditional methods of diet and exercise, but has been unable to do so. It is not a magic formula, but a tool that helps a person control the amount of food that one eats. After surgery, losing weight requires a commitment from an individual to eat healthy, eat less, and exercise. For those individuals who are ready to make the commitment to change, weight loss surgery may be just the tool that helps them succeed.

How Gastric Bypass Surgery Helps to Reduce Weight

Weight loss surgery focuses on two basic principles to facilitate weight loss: limit the amount of food eaten and limit the amount of food absorbed by the body. A restrictive procedure is one that limits the amount of food that can be eaten. A malabsorptive 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. Among the weight loss surgery options, some are primarily restrictive, while some use a combined approach.

Roux-en-Y Gastric Bypass Surgery

One of the most popular weight loss surgeries performed in the United States is the Roux-en-Y gastric bypass (RNY), a procedure that combines both restrictive and malabsorptive measures. The Roux-en-Y procedure was developed in the 1980's. Initially, the procedure involved cutting open the chest, but most surgeons now perform the procedure laparoscopically (inserting instruments into the abdomen thru small incisions).

In this procedure, the upper portion of the stomach is completely stapled shut and divided from the stomach pouch. A smaller stomach limits the amount of food that can be eaten (restrictive aspect). Then, a new outlet is formed in this smaller stomach pouch, which is connected to the lower intestine, bypassing much of the gastrointestinal tract. The rerouting of the intestine limits the amount of food and nutrients that can be absorbed by the body (malabsorptive aspect). The length of either section of the intestine can be made shorter or longer to affect the levels of absorption.

The most popular version of the Roux-en-Y is known as the short limb, or proximal (nearer to), gastric bypass. A modified version of this procedure moves the intestinal Y-connection further down the small intestine reducing food absorption even more. This procedure is known as the Distal (farther away) gastric bypass or long limb Roux-en-Y gastric bypass.

Biliopancreatic Diversion, Duodenal Switch Gastric Bypass Surgery

Two other gastric bypass procedures that combine restrictive and malabsorptive aspects are biliopancreatic diversion (BPD) and a newer modification known as biliopancreatic diversion with duodenal switch (DS). With BPD, a large part of the lower stomach is removed and the small part of the stomach that remains is attached directly to the last part of the small intestine. As food moves thru the body, it completely bypasses the first (duodenum) and middle (jejunum) portions of the small intestine. The variation of BPD called the duodenal switch (DS) retains more of the stomach including the valve that controls the release of food into the small intestine and the beginning of the first section (duodenum) of the small intestine.

Gastric Bypass Surgery

The biliopancreatic diversion and duodenal switch procedures are more complicated than the Roux-en-Y procedure and are performed by only a small amount of bariatric surgeons. Since they are considered somewhat experimental, the BPD and DS procedures are usually not covered by insurance. These gastric bypass variations offer sustained weight loss, but they require very close monitoring as they also have a greater risk of malnutrition and vitamin deficiencies. These procedures are generally only performed on patients who have a body mass index of 50 or higher.

Concerns and Risks of Gastric Bypass Surgery

People who choose gastric bypass surgery need to be well informed and aware of the health concerns and risks associated with having this type of procedure. Before undergoing surgery, patients should consider the expected changes in their life after gastric bypass. Due to the malabsorptive aspect of gastric bypass surgery, gastric bypass 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. Nutritional deficiencies cause serious health problems and must not be ignored. 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.

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 (gets bigger over time), erosion of the staple line or plastic band (separating the two stomach sections), leakage of the stomach contents into the abdomen (dangerous because stomach acid can eat away other internal organs).

Advantages of Gastric Bypass Surgery

While it is important to consider the risks associated with weight loss surgery, it is also important to consider the serious health consequences associated with morbid obesity. Gastric bypass surgery is performed as a life-saving measure to treat the disease of obesity. It helps someone who is extremely overweight 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 conditions related to obesity are either cured or improved, including diabetes type 2, sleep apnea, and hypertension (high blood pressure). Many gastric bypass patients are able to reduce their dependence on medications for these health conditions, saving money. Overall, gastric bypass surgery can help you enjoy a healthier life, a more active life, and a longer life.

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