Gastric bypass surgery also called Roux-en-Y (roo-en-wy), is one of the most common types of bariatric surgery performed when diet and exercise have failed to work or when you’re facing serious health problems due to your weight. This surgery shrinks the size of your stomach, therefore you can no longer eat as much as you used to.
A gastric bypass surgeon will also re-route, or bypass, part of your digestive system so you don't absorb as much food. After gastric bypass, swallowed food will go into this small pouch of the stomach and then directly into the small intestine, thereby bypassing most of your stomach and the first section of your small intestine.
What is gastric bypass surgery?
Gastric bypass surgery is a type of weight-loss surgery that reduces the size of the stomach and reroutes the digestive tract. It is also known as Roux-en-Y gastric bypass because it involves creating a small pouch from the upper part of the stomach and connecting it to the middle part of the small intestine, forming a Y-shaped configuration. The purpose of gastric bypass surgery is to help people with obesity lose weight and improve their health.
By creating a smaller stomach, the surgery limits the amount of food that can be eaten at one time, leading to a feeling of fullness with less food. By bypassing a portion of the small intestine, the surgery also reduces the absorption of calories and nutrients from the food, resulting in weight loss. Gastric bypass surgery can have many benefits for people who are severely overweight and have not been able to lose weight through diet and exercise. It can lower the risk of obesity-related diseases, such as type 2 diabetes, high blood pressure, high cholesterol, heart disease, stroke, sleep apnea, and some types of cancer.
It can also improve the quality of life and self-esteem of people who undergo the surgery. However, gastric bypass surgery also has some risks and complications, both during and after the procedure. Some of the possible risks include bleeding, infection, leakage, bowel obstruction, ulcers, hernia, gallstones, malnutrition, dumping syndrome, and low blood sugar. Gastric bypass surgery also requires lifelong changes in eating habits and lifestyle, such as eating smaller and more frequent meals, avoiding high-fat and high-sugar foods, taking vitamin and mineral supplements, exercising regularly, and following up with the medical team.
Why is gastric bypass surgery performed?
Gastric bypass surgery is done to help lose excess weight, therefore reducing your risk of potentially life-threatening weight-related health problems, including:
Gastroesophageal reflux disease
Heart disease
High blood pressure
High cholesterol
Obstructive sleep apnea
Type 2 diabetes
Stroke
Cancer
Infertility
Who is a good candidate for gastric bypass surgery?
Your body mass index (BMI) is 40 or higher (extreme obesity). Your BMI is 35 to 39.9 (obesity), and you have a serious weight-related health problem, such as type 2 diabetes, high blood pressure, or severe sleep apnea. In some cases, you may qualify for certain types of weight-loss surgery if your BMI is 30 to 34 and you have serious weight-related health problems.
Even if you are severely overweight, gastric bypass might not be for you. You’ll have an extensive screening process to see if you meet certain medical guidelines to qualify for weight-loss surgery. It doesn’t stop there, you also must be willing to make a permanent commitment to a healthier lifestyle. Afterward, you should participate in long-term follow-up plans that include monitoring your nutrition, your lifestyle and behavior, and your medical conditions.
Before gastric bypass surgery
Preparing for gastric bypass surgery is a process that involves physical, mental, and emotional aspects. It requires careful planning, education, and commitment to ensure a successful outcome. Here are some of the steps that you need to take to prepare for gastric bypass surgery:
Consult with your doctor: They will evaluate your medical history, weight, and health conditions to determine if you are a good candidate for the surgery. They will also explain the procedure, the risks, the benefits, and the expectations of the surgery. They will also provide you with preoperative and postoperative instructions and answer any questions you may have.
Follow a preoperative diet: About two to four weeks before the surgery, you will need to follow a low-calorie, high-protein, liquid diet. This diet will help shrink your liver and reduce the fat around your abdomen, making the surgery easier and safer. You will also need to avoid alcohol, caffeine, and carbonated drinks. The day before the surgery, you will only be allowed to drink clear liquids, such as water, broth, or sugar-free juice.
Stop smoking and taking certain medications: Smoking can impair your healing and increase the risk of complications after the surgery. You will need to quit smoking at least two weeks before the surgery and avoid any nicotine products. You will also need to stop taking any medications or supplements that can affect your blood clotting, such as aspirin, ibuprofen, vitamin E, or fish oil, at least 10 days before the surgery.
Preparing for hospital stay and recovery: You will need to arrange for someone to drive you to and from the hospital and to stay with you for the first night after the surgery. You will also need to pack a bag with comfortable clothes, personal items, and any medications that you will need. You will need to plan ahead for your recovery at home, such as preparing your meals, setting up your bed, and getting help from your family or friends.
What are the types of gastric bypass surgery?
Roux-en-Y gastric bypass
This type of gastric bypass offers a quicker recovery time since it can be done through a small cut. During the surgery, your surgeon will make a small stomach pouch by stapling parts of your stomach together or by vertical banding, limiting how much food you can eat. Then the Y-shaped section of the small intestine will be attached to the pouch. As a result, food will skip part of your digestive system, absorbing fewer calories and nutrients.
Extensive gastric bypass (biliopancreatic diversion)
A more complicated type of gastric bypass, during which the lower part of the stomach is removed. Afterward, the small pouch that remains, will be connected directly to the last part of the small intestine. As a result, completely bypasses the first two parts. Although this surgery helps with weight loss, it’s not widely used due to high complication rates and how it can leave you short on nutrients.
What are the risks of gastric bypass surgery?
As with any major surgery, gastric bypass and other weight-loss surgeries pose potential health risks, both in the short term and long term. Risks are similar to any abdominal surgery:
Excessive bleeding
Infection
Adverse reactions to anesthesia
Blood clots
Lung or breathing problems
Leaks in your gastrointestinal system
Longer-term side effects of gastric bypass can include:
Bowel obstruction
Dumping syndrome, causing diarrhea, nausea, or vomiting
Gallstones
Hernias
Low blood sugar (hypoglycemia)
Malnutrition
Stomach perforation
Ulcers
Vomiting
In some rare cases, complications of gastric bypass can be fatal.
Benefits of gastric bypass operation
Gastric bypass operation can be a life-changing and life-saving procedure for some people, but it is not for everyone. It involves risks and complications, both during and after the procedure. Gastric bypass surgery also requires lifelong changes in eating habits and lifestyle, such as eating smaller and more frequent meals, avoiding high-fat and high-sugar foods, taking vitamin and mineral supplements, exercising regularly, and following up with the medical team. Gastric bypass surgery is not a quick fix or a magic solution for obesity. It is a major surgery that involves risks, benefits, and responsibilities. Some of the benefits of gastric bypass surgery are:
Improved quality of life: Many people who have gastric bypass surgery report improved physical and mental well-being, self-esteem, social interactions, and work performance.
Reduced or resolved comorbidities: Gastric bypass surgery can improve or resolve conditions that are often related to obesity, such as high blood pressure, high cholesterol, type 2 diabetes, obstructive sleep apnea, gastroesophageal reflux disease, and nonalcoholic fatty liver disease.
Increased life expectancy: Gastric bypass surgery can lower the risk of death from obesity-related causes, such as cardiovascular disease and cancer.
Reduced medication use: Gastric bypass surgery can reduce the need for medications to treat obesity-related conditions, such as diabetes, hypertension, and dyslipidemia.
What results can you expect from gastric bypass surgery?
Gastric bypass can provide long-term weight loss. Of course, the amount of weight you lose depends on the type of surgery and changes you make in your lifestyle. In total, it’s possible to lose about 70% or even more of your excess weight within two years. Also after a gastric bypass, some of the conditions often related to being overweight can be improved or resolved, which include:
Gastroesophageal reflux disease
Heart disease
High blood pressure
High cholesterol
Obstructive sleep apnea
Type 2 diabetes
Stroke
Infertility
Also with gastric bypass, you’ll witness improvement in your ability to perform routine daily activities, which could help improve your quality of life.
When might weight-loss surgery not work?
It's possible to not lose enough weight or to regain weight after weight-loss surgery. If you don’t commit to the lifestyle change, and snack frequently on high-calorie foods or such, you may not see the results of your surgery. It's important to keep all of your scheduled follow-up appointments after weight-loss surgery so that your doctor can monitor your progress. If you notice that you aren't losing weight or you develop complications after your surgery, see your doctor immediately.
Gastric bypass surgery Recovery
The recovery time and the steps you need to take depend on the type and depth of the surgery you received. Generally, there are two types of gastric bypass surgery: laparoscopic and open. Laparoscopic surgery involves making small incisions in your abdomen and using a camera and instruments to perform the surgery. Open surgery involves making a larger incision and directly accessing your stomach and intestines.
Laparoscopic gastric bypass surgery recovery usually takes shorter and requires less care than open gastric bypass surgery recovery. It can take from two to four days to leave the hospital and from three to five weeks to resume normal activities. During this time, you may experience some side effects, such as pain, nausea, vomiting, diarrhea, gas, or bloating. To minimize these side effects and prevent complications, you need to follow the postoperative instructions given by your doctor, such as:
Drinking plenty of fluids to stay hydrated and avoid dehydration.
Eating small, frequent, and nutritious meals that are low in fat, sugar, and fiber.
Take vitamin and mineral supplements as prescribed by your doctor to prevent deficiencies.
Avoiding alcohol, tobacco, and nonsteroidal anti-inflammatory drugs that can irritate your stomach and intestines.
Walking and doing light exercises to improve your blood circulation and prevent blood clots.
Seeking medical attention if you have any signs of infection, leakage, bleeding, or bowel obstruction, such as fever, chills, redness, swelling, pus, drainage, severe pain, or difficulty passing stools.
Open gastric bypass surgery recovery usually takes longer and requires more care than laparoscopic gastric bypass surgery recovery. It can take from five to seven days to leave the hospital and from six to eight weeks to resume normal activities. The side effects and the postoperative instructions are similar to those of laparoscopic surgery, but they may be more severe and last longer.
Conclusion
Gastric bypass operation is a type of weight-loss surgery that can help people with obesity lose excess weight and improve their health. It involves creating a small pouch from the stomach and connecting it to the lower part of the small intestine, bypassing most of the digestive system. This reduces the amount of food intake and calorie absorption, leading to significant weight loss and lower risk of obesity-related diseases, such as diabetes, heart disease, and sleep apnea.
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