Laparoscopic Gastric Bypass Surgery
Patients who undergo bariatric surgery, either laparoscopic gastric bypass or laparoscopic gastric banding, experience significant weight loss after surgery. Both operations decrease the size of the functional stomach, causing an individual to feel full faster. This lowers the amount of food that one consumes and can significantly lower the number of calories consumed.
Why Laparoscopic Gastric Bypass Surgery?
Obesity is a worldwide problem of increasing prevalence. Ideally, and in its less severe stages, obesity can be controlled with diet management and a regular exercise program. At times, obesity may be so severe that it is termed morbid obesity. Medically, this term is defined as a body mass index (BMI) greater than 40 kg/m^2. Although this calculation depends upon both an individuals height and weight, persons who are approximately 100 pounds over their ideal body weight are likely to be morbidly obese.
The decision to proceed with surgery always represents a comparison between risks and benefits, as any surgical procedure involves some risk. Generally accepted criteria for proceeding with this type of surgery include that an individual have been obese for at least five years, be between the ages of 18 and 65 years and have no medical or psychiatric contraindications to undergoing surgery. Candidates must also have failed a regimented and organized diet program for at least six months.Other criteria include an organized set of measurements. Those who have a BMI greater than 40 or those with a BMI of 35 or more who are also suffering from life-threatening illnesses curable with weight loss are considered as possible candidates for bariatric surgery. Something to remember, however, is that is not acceptable to undergo bariatric surgery if you suffer from untreated depression or any other major psychiatric disorder.
What occurs during laparoscopic gastric bypass?
In this surgery, the stomach is sewn or stapled to create a smaller stomach pouch that can hold only hold about a half-cup of food. The idea behind the pouch is that an individual feels full more quickly with a smaller stomach, and thus eats less. This is called the restrictive part of laparoscopic gastric surgery, as it restricts food intake. In the bypass part of the surgery, the small stomach pouch is disconnected from the first part of the small intestine, called the duodenum, and then reconnected to a portion of the small intestine further downstream, called the jejunum. This technique is called a roux-en-Y intestinal bypass. Once in place, food passes from the stomach pouch directly into the jejunum, bypassing the duodenum. Because of this bypass, there is reduced absorption of calories and nutrients. This accounts for this portion of the operation being classified as malabsorptive. Like other laparoscopic operations, the laparoscopic gastric bypass is performed using a tiny camera called a laparoscope and requires only a few small incisions on the abdominal wall.
The operation takes anywhere from one to three hours, depending on a number of factors including whether or not an individual has had a previous abdominal operation, the persons gender and the BMI. Laparoscopic Gastric Bypass is a different operation than the Laparoscopic Gastric Band. Although the incisions are similar, there are many physiological differences between the two operations. Those who undergo laparoscopic gastric bypass start losing weight quickly after the surgery. Weight loss is marked and lasts about one and a half years.� After that period of time, the body compensates for the surgery and weight loss stops. Those who undergo the Laparoscopic Gastric Band procedure loose weight more slowly, but the weight loss is sustained for a longer period of time.
Life After Surgery
Patients typically stay in the hospital between two and four days after a Laparoscopic Gastric Bypass. The criteria that determine when a patient is ready to return home include being able to eat and drink a certain amount of liquid each hour and no longer needing any injectable pain medications. A typical post-gastric bypass diet consists of liquid and pureed food for a few weeks after surgery. Immediately after the surgery, patients feel full quickly because the stomach will only be able to hold a tablespoon of food. The reason for this temporary change in diet is that the connection that the surgeon creates between the stomach pouch and the intestine swells after surgery. This swollen connection causes the food that is in the stapled part of the stomach to pass at a slow rate. This change is temporary and once all the healing and swelling is complete, the stomach will be able to hold a maximum of one half-cup of thoroughly chewed food.
Laparoscopic gastric bypass is meant as a means to a healthier and long-lasting life, which requires dedication and hard-work. It is very important that patients considering bariatric surgery spend the time to speak to others who have had the surgery. Although doctors can predict some of the body changes that occur after this surgery, there are many emotional and lifestyle changes that occur with bariatric surgery that only someone who has had the surgery can understand and explain.
Risks with Laparoscopic Gastric Bypass
As is the case with all surgery, there are risks associated with gastric bypass. They include an infection at the site of the incision, a leak from the stomach to the abdominal cavity or from the intestinal connection and a blood clot that can travel to the lung. Frequent follow up with Dr. Belsley in the first year after the surgery and on a regular basis from that period forward is important to the success of the surgery. Dr. Belsley works with a dietician to provide you with the appropriate recommendations to make surgery a continued success. All patients must take vitamin supplements after the laparoscopic gastric bypass. This regime will be tailored by checking vitamin levels periodically.