Gastric Bypass Surgery
Weight loss surgery, or bariatric surgery, is performed to change the digestive tract, prompting weight loss. It is intended for morbidly obese patients who have not found success at weight loss through diet and exercise alone. Gastric bypass surgery is the most commonly performed type of weight loss surgery, accounting for nearly 80 percent of all such procedures. This procedure is performed to decrease stomach size as well as the length of the small intestine. This approach is known as both a malabsorptive and a restrictive method of bariatric surgery; the procedure both restricts the amount of food that can be eaten, and limits the absorption of this food in the intestine.
Are you a good candidate?
You may be a candidate for gastric bypass surgery if you are at least 80 to 100 pounds overweight and have tried dieting and exercising without successfully losing weight. Most candidates for gastric bypass surgery have a body mass index (BMI) of at least 35 to 40. In order to undergo this procedure, patients must also be willing to commit to diet and lifestyle changes both before and after surgery.
Procedure
Gastric bypass surgery is either performed through a lengthy incision in the abdomen (a technique known as open surgery) or through a smaller incision, aided by a camera and specialized surgical instruments (known as laparoscopic surgery). It requires general anesthesia and between three to five hours, depending on the surgeon and the particular surgical technique being performed.
During Roux en Y surgery, the surgeon creates a pouch at the top of the stomach using surgical staples. This pouch is then connected directly to the lower part of the small intestine. This bypasses part of the stomach and the upper portion of the intestine.
Biliopancreatic diversion bypass, or BPD, is less common than the Roux en Y technique. Like other forms of gastric bypass surgery, this procedure – of which the duodenal switch is one method – also makes the stomach smaller, while bypassing part of the small intestine so that fewer calories are absorbed. The major difference between these techniques is that with BPD, the bile and pancreatic juices are diverted so that they meet the ingested food earlier, in order to further reduce calorie absorption.
Once the necessary surgical work has been completed, the abdominal incisions will be closed with sutures. Finally, the incision site will be covered in a surgical dressing.
Complications & Risks
The risks of gastric bypass surgery must be weighed against the known health risks of obesity. While patients who undergo gastric bypass surgery often find that the procedure has a positive effect on a range of medical conditions associated with obesity, such as heart disease and diabetes. However, the procedure can also come with negative health effects. This procedure is considered major abdominal surgery, the risks of which include infection, ulcers, stomach perforations, and gallstones. After surgery, meals high in sugar or fat may cause ‘dumping,’ the symptoms of which include diarrhea and abdominal cramps. If the necessary nutritional supplements are not taken after surgery, malnutrition or nutritional deficiencies can occur.
Gastric Bypass Surgery Recovery Time
Most patients spend one to three nights in the hospital following surgery. They can then expect about six to eight weeks for a full recovery, although many patients are able to return to work after about two to three weeks. After surgery, patients must make significant lifestyle changes. This is particularly true with regards to food. After surgery, the stomach can only hold a few ounces, and patients must commit to eating small meals that are low in sugar and fat. In addition, patients must take daily dietary supplements to replace nutrients no longer absorbed by the intestine.
Over time, patients can expect to lose about 50 to 80 percent of their excess weight, depending on their starting weight and commitment to the lifestyle changes necessary for weight loss.
Gastric Bypass Cost
The average cost of gastric bypass surgery is about $18,000 to $30,000. This cost depends on the specific technique chosen and the surgeon performing the procedure, among other variables. Part or all of the procedure may be covered by health insurance. In order to qualify for insurance coverage, you may need to submit medical tests or a letter from your doctor attesting to the medical necessity of the surgery.