Gastric bypass is a bariatric surgery designed for those who have been unable to lose weight through diet and exercise. It works by restricting food intake and food absorption to promote weight loss. Bariatric surgeries have increasingly become a preferred option to deal with obesity and obesity's health-related issues. The American Society for Metabolic and Bariatric Surgery reported that the number of bariatric surgeries in the United States doubled from approximately 103,000 in 2003 to about 220,000 in 2008.
Patient Requirements
There is a screening process to ensure a potential patient he meets the psychological and medical requirements for gastric bypass surgery. A body mass index (BMI) of 40 or higher is usually required. If the individual's BMI is from 35 to 39.9, he is eligible for surgery only if serious obesity-related health problems exist. Individuals work with a team of professionals to assess their readiness for surgery. Teams consist of a dietitian, psychologist, physician and surgeon. Teams assess an individual's willingness to comply with diet and exercise requirements, current health, lifestyle and pre-existing conditions. The benefits of surgery need to outweigh the risks.
Preparation
If he smokes, he must quit several weeks before surgery. A week before surgery, individuals must refrain from taking aspirin, ibuprofen, vitamin E, warfarin and any other drugs that inhibit blood clotting. People do not eat or drink anything after midnight the night before surgery.
Process
Gastric bypass surgery uses general anesthesia and lasts approximately four hours. Hospital stays range from three to five days. The person cannot eat for one to two days after the surgery and then must follow a specific 12-week diet. The diet has three stages. Stages are liquid only, ground-up or soft food and regular food.
Types
Roux-en-Y is an open surgery technique where the surgeon makes a large incision to open the abdomen. The laparoscopic technique is less invasive. The surgeon makes short incisions in the abdomen and uses the laparoscope to navigate within the stomach. The laparoscope is a small, tubular surgical instrument with a camera attached so that the surgeon can view inside the abdomen via a monitor. For both Roux-en-Y and laparoscopic surgical techniques, the surgeon staples the stomach across the top, closing it off from the rest of your stomach. The resulting stomach pouch is the size of a walnut. The surgeon cuts the small intestine and connects it to the pouch. The biliopancreatic diversion with duodenal switch technique is typically used for individuals with a BMI of 50 or higher. In this, the surgeon removes 80 percent of the stomach.
Risks
Gastric bypass surgery risks include gallstones, dehydration, kidney stones, hernia at incision site, vitamin and mineral deficiency and low blood sugar. The Roux-en-Y gastric bypass procedure has several additional risks, including death, blood blots in legs, pneumonia, leaking at one of the staple lines in the stomach, narrowing of the opening between the stomach and small intestine, and dumping syndrome. Dumping syndrome occurs when food passes too quickly through the small intestine, causing nausea, vomiting, sweating, diarrhea and dizziness. The additional risk associated with biliopancreatic diversion with duodenal switch technique is malnutrition.
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