Roux-en-Y gastric bypass surgery
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Roux-en-Y gastric bypass surgery, or simply gastric bypass surgery, is a procedure almost exclusively used in surgical weight-loss applications to correct morbid obesity. The procedure involves stomach stapling to reduce the stomach to a "pouch" of 30-60 mL (1–2 fl. oz.) in capacity and connecting this pouch at a point midway along the small intestine. The larger portion of the stomach is left in the body and is connected to the small intestine further down, in order to allow the introduction of gastric juices that are essential for digestion. The surgery varies in length and can be performed through a 6–8 inch vertical incision in the abdomen or through a number of small incisions (see laparoscopic surgery). The length of hospital stay after the surgery varies, but usually lasts 2–7 nights.
Gastric bypass surgery has two main results: the tiny stomach pouch means that the patient is able to eat only very small portions of food at a time, drastically reducing intake of calories; and the shortened digestive tract prevents those calories from being fully absorbed. This is why gastric bypass surgery is classified as both a restrictive (reducing intake) and malabsorptive (reducing absorption) procedure.
Indications
Gastric bypass surgery is recommended only for patients who are morbidly obese, usually more than 100 pounds (45 kg) overweight. These individuals have major health problems related to their weight. The Body Mass Index BMI is typically used to identify surgery candidates with a cut-off of 40 being used by most surgeons. BMIs down to 35 are typically permitted if the individual has other serious health issues.
Gastric bypass is overwhelmingly successful, with many patients losing over 100 pounds within the first 18 months following surgery. Gastric bypass surgery should always be accompanied by an exercise regimen.
Lifetime commitment
Undergoing a gastric bypass requires patients to commit to a new lifestyle. They will no longer be able to eat large portions of food at one sitting, nor will they be able to eat foods high in sugar or fat, which often result in dumping syndrome, an unpleasant feeling of faintness caused by the sudden absorption of these foods in the shortened digestive tract. Due to the limited amount patients can take in at any one time, they must constantly drink small amounts of water or risk dehydration.
The operation while highly sucessful does have a morbidity rate of approximately 2% overall. 1% having immediate complications and death; another 1% will commonly have post-operative complications that lead to death within one month of surgery. This can be mitigated by compliance with the surgeon's post-operative plan and using a doctor who has performed more than 200 procedures.
However, it should be noted that a full 25% of people undergoing this operation will have some form of post-operative complication either requiring a further procedure or change in habits. In some instances, the production of an intrinsic factor in the stomach wall to aid in vitamin B12 absorption is decreased. This may call for B12 shots for life to aid in the breakdown of food for energy.
External links
- Gastric Bypass Surgery Information (http://gastric-bypass.20roundmag.com)
- American Society for Bariatric Surgery (http://www.asbs.org/)
- One patient's very detailed diary (http://www.basilwhite.com/gastric/)
- Obesity Help website (http://www.obesityhelp.com/)
- An ongoing blog as one patient goes through the process (http://www.fatjewguy.com/)
- Gastric Bypass News and Surgeon Directory (http://www.gastricbypassanswers.com/)