Gastric Bypass
The laparoscopic Roux en-Y gastric bypass is the gold standard for weight loss surgery. Gastric bypass is a surgical procedure designed specifically for weight loss. It restructures the digestive tract so the patient consumes fewer calories and still feels full. Gastric bypass combines the creation of a small stomach pouch with a bypass of the area of the small intestine known as the duodenum. The smaller stomach size means that patients feel full after much smaller meals. Bypassing the duodenum also means fewer calories and nutrients are absorbed by the body. The result is dramatic weight loss that helps obese patients achieve an improved state of health.
Who can have Gastric Bypass?
Gastric bypass is generally recommended for patients who have a body mass index of 40 or more. It is also used on patients who have a chronic medical condition directly associated with excess weight. It can be effective for patients who have been classified as obese for five or more years and have been unable to lose weight through other methods. This surgery is generally restricted to patients between the ages of 18 and 65. It is not recommended for patients who have psychiatric disorders like depression unless the condition is controlled with medication. People with an alcohol addiction are not good candidates for gastric bypass.
What are the Benefits?
Gastric bypass has proven to be one of the most effective weight loss surgeries. According to the Mayo Clinic, patients can expect to lose 50-60% of excess weight in the first two years after surgery. Some websites place that estimate even higher. Because lifestyle changes are required after the surgery, success of the procedure is largely dependent on the patient. In addition to the dramatic weight loss, many patients have seen improvement or resolution of chronic conditions, including:
All of these conditions can be caused or exacerbated by obesity. Because they are serious and even life threatening, the ability to minimize or eliminate them is a large benefit of gastric bypass surgery. It may also be the primary reason physicians recommend the procedure to some of their patients.
How is the Procedure Done?
Roux-en-Y is the most common procedure used for gastric bypass. During Roux-en-Y, the surgeon staples off the top of the stomach, leaving a small pouch about the size of a walnut. This pouch is attached directly to a portion of the small intestine, located past the duodenum. Food is passed from the pouch directly to this section of the small intestine, leaving the rest of the stomach and duodenum out of the digestive process entirely.
The procedure can be done with a large incision across the stomach, known as open gastric bypass. However, many surgeons are now performing the procedure using a smaller incision and laparoscopic tools to guide the process. This is known as laparoscopic gastric bypass, which usually results in a shorter recovery time and fewer possible complications. Both procedures are done under a general anesthesia.
What is the Recovery Like?
Depending on the surgery performed, the patient may remain in the hospital for two to five days after the procedure. No food is offered for the first day or two, allowing the stomach time to heal. Food is added gradually over the next 12 weeks and it is essential that patients follow the dietary guidelines set by their doctor during this time. Most patients return to normal activities within two to five weeks.
Weight loss from gastric bypass is fast and dramatic and continues for at least the first twelve months after the procedure. While some patients gain a portion of the weight back, this procedure usually results in less rebound weight gain than other types of weight loss surgery. Patients will be counseled on appropriate lifestyle changes like diet, exercise and supplementation. Because the body is not able to absorb as many nutrients after gastric bypass, most doctors recommend some sort of supplementation to prevent deficiencies.
Gastric bypass does include similar risks to other types of surgical procedures and it is not right for everyone. However, if you are significantly overweight and have not been able to lose weight using traditional measures, this may be an effective weight loss method for you. Talk to your doctor about whether you are a good candidate for gastric bypass and find out if better health is on your horizon.
LAP-BAND is a surgical procedure designed to assist in the weight loss process. The device is similar to gastric bypass, in that it alters the anatomy of the digestive system so patients can eat less food and still feel full. Unlike gastric bypass, LAP-BAND is minimally invasive and there are fewer risks associated with this procedure. The band also offers unique adjustability that allows doctors to inflate the device over time for even better weight loss results.
Who should have the LAP-BAND Procedure?
LAP-BAND is recommended for patients who are 100 pounds or more overweight or who have a body mass index of at least 40. Those with a BMI less than 40 who have medical conditions associated with obesity may also qualify for the LAP-BAND procedure. These patients may have been overweight for five years or more and have tried other means of weight loss to no avail. Patients need to be in reasonably good health to have the surgery and be willing to commit to lifestyle changes after the procedure to ensure optimal results.
What are the Benefits of LAP-BAND?
The primary benefit to the LAP-BAND procedure is that it assists in weight loss when other systems have failed. This weight loss reduces the risk of many potentially serious conditions such as type-2 diabetes, high blood pressure and cholesterol and some forms of sleep apnea. In patients that have already been diagnosed with these conditions, the weight loss associated with LAP-BAND may be sufficient in minimizing or reversing them.
How is the Procedure Done?
LAP-BAND is done by laparoscopy, which is a minimally invasive surgical procedure that results in fewer risks and a shorter recovery time. The surgeon makes a series of small incisions, into which he inserts a tiny camera to visualize the placement of the band. The band is placed around the top part of the stomach and held there by sutures. A port is attached to the band and threaded just below the surface of the skin in the abdominal region. The doctor uses the port to adjust the opening of the band as necessary, by injecting saline solution through the port directly into the band device.
The LAP-BAND procedure is done under general anesthesia and takes approximately one hour to complete. Because it is done by laparoscopy, patients usually experience less discomfort and fewer complications during and after the procedure. Some patients are able to leave the hospital the same day, while others require an overnight stay for observation. Most return to work within a week after the procedure.
What is the Recovery Like?
Patients are generally restricted to a liquid or soft diet for two weeks after the surgery. As solid food is reintroduced, patients will be instructed on how to modify their diets to assist with weight loss. Vitamin supplementation might also be required to ensure deficiencies do not occur. Most patients are also provided with an exercise program.
Patients who stick with their prescribed programs will usually see a gradual weight loss over a period of many months. Some even continue to lose weight for four or five years after surgery. Typical weight loss is around 50-60% of excess weight within two years. Since weight loss is dependent on lifestyle changes, the success of the procedure is determined in part by the patient.
LAP-BAND is not right for everyone, but it can be an effective method of weight loss for people who are at higher risk for potentially dangerous medical conditions because of their weight. If you have a BMI of 40 or more, or you have been diagnosed with a weight-related medical condition, talk to your doctor to see if LAP-BAND is the right choice for you.
Join us on Facebook