Gastric Bypass

What is gastric bypass surgery?

This surgery is an option for those patients who tried dieting methods and exercises but were unsuccessful. They dream of having a healthy, thin, and beautiful body shape in a reasonable amount of time. Gastric bypass surgery is the most common type of weight-loss surgery. It is a surgery that helps lose weight by changing how the stomach and small intestine handle the food intake. This surgery is contraindicated for alcohol and drugs abusers and if an active gastric ulcer exists, the surgery should be postponed to the time that ulcer healing is completed.

Who is a good candidate?

• Patients whom BMI is above 40
• Patients whom BMI is between 30-40 with life threating problems like diabetes, hypertension, heart disease, high cholesterol and severe sleep apnea
• Patients older than 18 years old • Patients must be willing to make major changes in their lifestyle

Types of gastric bypass

There are two different methods for gastric bypass surgery; open surgery and laparoscopically. Nowadays, often laparoscopically surgery is preferred because it has less complications and scars. In addition, laparoscopically surgery recovery time is faster. In this method, after administering the anesthetics, the surgeon makes four to six small incisions on the abdomen and inserts the instruments and camera. This camera helps the surgeon to see inside of the abdomen during the operation.

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Before the procedure

The bariatric surgeon may recommend a pre-operative diet of two weeks before the surgery which has protein but carbohydrates and fat limitations. This diet makes body ready for the surgery. Patients should tell the surgeon their complete medical history, allergies, medicines and supplements. Patients may ask to stop taking some medicines like aspirin, warfarin, ibuprofen or vitamin E a week before the surgery and whole patient’s medicines are adjusted before the surgery. Women are also questioned about their pregnancy status or their intention to become pregnant. They are being asked to do lab tests and physical exams to make sure that this surgery can be done for them. It is important to know that patients should try to stop smoking for better outcomes and they should stop smoking at least 30 days before surgery.

During the procedure

This surgery is done under general anesthesia. In general, the surgeon punches the upper part of the stomach and seals it from the other parts. This punched part volume is only 30 milliliters. In the next step, small intestine is cut and attached to the punched stomach. So the food does not pass through much of the stomach, as well as the beginning of the small intestine, and directly enters the middle part of the small intestine. Skipping that parts along with less stomach volume, results in less calorie absorption.

After the procedure

Patients feel pain after the anesthesia gone, so they need pain killers. The surgeon is likely to recommend standing and walking on the same day at least three times a day. Patients can drink a small portion of liquids on the first day, but solid foods are should be avoided up to the time that the digestive system is healed. They should follow a special regimen for 12 weeks, it starts with liquids and then gradually diluted soup, pureed and soft food and at the end regular foods are added to the regimen. Patients should take about two liters of liquids in small portions to prevent dehydration daily. On the first few weeks after surgery patients should only rest and physical activity and home affairs are forbidden. During the recovery time, patients may need more sleeping. While sleeping, it is better to use several pillows under scapula and head to prevent heartburn and reduce abdominal pain. Multivitamins and mineral supplements are prescribed by the doctor to supply nutrients like iron, calcium and vitamin B-12. After the surgery, the patients need follow up visits, usually at the end of the first week, one month after the first visit and then on the third, sixth, twelve months after surgery. (The follow ups can be done by any expert by patient’s medical record which will be given to patient)

Scars

Probable scars

Discomfort

Mild to Moderate (controlled with prescriptions)

Duration of results

The results are long lasting but it is reversible (depends on life style modification)

Potential risks

 Soreness, swelling or pain, bleeding, diarrhea, infection

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