What is a Gastric Bypass?
Gastric Bypass, which can be performed as Roux-en-Y Gastric Bypass or Mini Gastric Bypass, is a weight loss procedure that combines restriction and metabolic changes with a mild malabsorptive component. During the surgery, a small pouch is created at the top of the stomach, redirecting the flow of food away from the first part of the small intestine and directly into the middle section. The weight loss effects are primarily achieved through:
Restriction of food intake due to the smaller stomach pouch
Alteration of gut hormones by diverting food away from the initial part of the small intestine Additionally, there is a partial reduction in food absorption.
The expected excess weight loss ranges from 65% to 75%. Individual results may vary.
Why Consider Weight Loss Surgery?
Weight loss surgery is the most effective and sustainable long-term treatment for weight loss. It reduces the risk of developing obesity-associated cancers. It can prevent, improve, or even cure conditions such as Type 2 diabetes and other obesity-related diseases. It can enhance fertility, especially in individuals with Polycystic Ovarian Syndrome, and contribute to a longer, happier, and healthier life. At Melbourne Weight Loss Centre, we offer personalized treatments tailored to your individual needs and existing medical conditions.
Why Choose a Gastric Bypass?
Roux-en-Y Gastric Bypass has been considered the "Gold standard" of bariatric procedures since its introduction in 1967. It offers greater efficacy in weight loss and has a better chance of normalizing blood sugar levels in Type 2 diabetic patients compared to other weight loss procedures. Additionally, it is the preferred option for individuals with severe reflux or heartburn.
Who is a Suitable Candidate for a Gastric Bypass?
Gastric Bypass may be suitable for individuals who:
Desire greater and more durable weight loss, accepting potential long-term side effects like vitamin deficiencies. Prefer a reversible procedure. Have poorly-controlled or uncontrolled diabetes and seek a better chance of cure. Experience severe reflux or heartburn. Have previously undergone unsuccessful weight loss procedures like gastric banding or gastric sleeve.
Indications for Gastric Bypass Gastric Bypass surgery is indicated for morbidly obese individuals meeting the following criteria:
BMI is ≥ 40. BMI is 35-39.9 with one or more associated co-morbidities. BMI is 30-34.9 with uncontrolled or poorly controlled Type 2 diabetes and multiple anti-diabetic medications.
Please note that these are guidelines and should be used for educational reference. The suitability for surgery should be assessed by a qualified doctor on a case-by-case basis.
Advantages of Gastric Bypass
The advantages of gastric bypass include:
Superior weight loss efficacy compared to gastric band and sleeve gastrectomy. Higher rate of resolution or improvement of obesity-related conditions. Reversibility of the procedure. Effective treatment for severe reflux or heartburn. Potential for better control of uncontrolled or poorly controlled Type 2 diabetes. No implant device left in the body.
Disadvantages of Gastric Bypass
Technically more complex than gastric banding or sleeve gastrectomy. Potential for greater long-term side effects compared to gastric sleeve, such as dumping syndrome, stomal ulcer, and internal hernia. Risk of vitamin deficiencies (particularly iron, B12, calcium, and folate) requiring regular monitoring. Strict adherence to lifelong vitamin/mineral supplementation and dietary recommendations is necessary. Increased follow-up requirements compared to gastric sleeve. Risks and Complications of Gastric Bypass Like any surgery, gastric bypass carries potential risks, but the rates of complications are relatively low according to recent publications.
Immediate/early complications may include:
Internal bleeding.
Infection.
Blood clots in the legs or lungs.
Leaks along staple lines or joints between stomach and small intestine.
Late complications may include:
Dumping syndrome (abdominal cramping, bloating, diarrhea, flushing, sweating, and palpitations). Narrowing of the joint between stomach and small intestine. Ulceration at the joint between stomach and small intestine. Internal hernia causing bowel obstruction. Protein malnutrition and vitamin deficiencies. Gastric Bypass Procedure Gastric bypass surgery is performed laparoscopically (key-hole surgery) under general anesthesia. The surgeon creates 5 small incisions in the abdominal wall to insert a camera and surgical instruments.
The procedure involves reducing the amount of food the stomach can store by creating a small stomach pouch using a stapler/cutting device. The flow of food is then redirected to the middle segment of the small intestine, bypassing the initial part.
The upper segment of the small intestine is divided, and the lower section (Roux limb) is attached to the stomach pouch. The upper section, which carries bile and digestive juices, is joined to the lower end of the Roux limb. The last segment, known as the "Common limb," allows food to mix with digestive enzymes.
Post-operative Care for Gastric Bypass
After the surgery, the hospital stay is typically 3-4 days. Painkillers and anti-nausea medications are prescribed for comfort. Early mobilization is encouraged to prevent complications like blood clots, respiratory problems, and bedsores. Swelling in the stomach may make drinking challenging initially, but it's important to sip water throughout the day to avoid dehydration, especially in the first 1-2 weeks.
A liquid diet is followed for the first 1-2 weeks post-op, transitioning to pureed and soft diets every 1-2 weeks, depending on recovery progress. Specific diet plans and instructions will be provided by the surgeon or dietician. Medication to reduce stomach acid production is prescribed for the first 3 months, and lifelong intake of multivitamins is necessary.
