Formerly called roux-en-Y, gastric bypass bariatric surgery is the most commonly performed bariatric procedure. The most important benefit of gastric bypass surgery, besides successful weight loss, is its ability to improve and often eliminate the medical diseases associated with obesity in more than 90%.
Diabetes, hypertension, as well as other medical problems are cured in a large majority of patients. Gastric bypass is both a restrictive and a malabsorptive procedure. The restrictive part of the procedure is the creation of the small stomach pouch with a small outlet. The malabsorptive part of the procedure involves cutting and then re-arranging the proximal small intestine.
Gastric Bypass Procedure
Six small incisions are made to allow insertion of a small scope that is connected to a video camera and the tools needed to perform the operation.
The gastric bypass surgeon will divide the stomach into two sections, forming a small pouch of less than one ounce that serves as the new stomach. This limits the amount of food that can be eaten at one time. It also provides a feeling of fullness and satisfaction with smaller portions of food. The larger, remaining section of the stomach is still joined to the digestive tract and remains functional by continuing to secrete digestive juices; however, this part of the stomach no longer receives food.
During gastric bypass bariatric surgery, a section of the small intestine called the jejunum is then pulled up to directly connect to the small stomach pouch. The other end of the small intestine is surgically reconnected at a point further down the small intestine. The shape of the intestine now somewhat resembles a "Y." When food is eaten, it enters the new stomach, then travels into the lower part of the intestine, bypassing the lower stomach and upper part of the intestine.
A major benefit of this rerouting is that the hormones promoting poor blood sugar control are almost immediately affected, often allowing patients to significantly reduce or eliminate their diabetes medications immediately after surgery. In addition, gastric bypass surgery seems to diminish the appetite and promote satiety or fullness.
Because the body absorbs fewer calories and nutrients, patients are at increased risk for nutritional deficiencies. Therefore, after gastric bypass surgery, it will be important to follow a physician's guidelines for nutritional supplementation.
This procedure can be performed as an open or laparoscopically. Laparoscopic gastric bypass surgery takes approximately 90 minutes and patients generally spend one or two days in the hospital. They may return to work in as soon as one week. Advantages of laparoscopic compared to open bypass include lesser blood loss, shorter hospitalization, reduced postoperative pain, faster recovery and fewer wound complications (incisional hernias and infections).
Weight loss is faster than with Lap-Band® surgery, with most patients losing more than 100 pounds or 65 to 70 percent of their target weight loss in the first year. Average weight loss is about 125 pounds in Beaumont patients.