Gastric Bypass
Procedure
During gastric bypass malabsorptive surgery, bariatric surgeons shrink
the size of the stomach either by using stomach staples (roux-en-y, biliopancreatic
diversion bypass) or a gastric band/silastic ring (fobi pouch bypass).
After this, the digestive food-pathway is changed, so the food bypasses
the early section of the small intestine, thus reducing the amount of
calories (and nutrition) which can be absorbed. Some bypass operations
bypass the duodenum and jejunum completely and connect the stomach directly
to the ileum, the final part of the small intestine. This drastically
reduces calorie absorption. Other less severe operations ( roux-en-y)
bypass a smaller length of the intestine.
Nutritional Deficiency Effects of Stomach
Bypass
Several important nutrients (calcium and iron) are digested in the bypassed
length of the small intestine, so one of the main post-operative risks
of gastric bypass operations is chronic malnutrition. Thus lifelong vitamin
and mineral supplementation is mandatory for all stomach bypass patients.
Gastric Bypass Offers Significant Weight
Loss
Stomach bypass surgery is able to produce significant post-operative weight
loss, which potentially makes it a very effective treatment for morbid
obesity. Bypass patients typically lose 66 percent of their pre-operative
excess weight within two years and maintain this weight reduction for
at least 5 years. Malabsorptive surgery are generally more effective for
long-term weight reduction than restrictive procedures such as lap band.
Complications of Stomach Bypass
Typical complications of this operation are anastomotic leakage, marginal
ulcer, dumping sydrome (rapid gastric emptying), long-term nutrient deficiencies
and weight regain along with a mortality rate of 0.12.5 percent.
About 10-20 percent of stomach bypass patients require follow-up operations
to correct complications (eg. hernias). More than one-third of obese patients
who have gastric bypass surgery develop gallstones. Laparoscopic or laparoscope-assisted
gastric bypass surgical techniques are equally safe and effective.
After Gastric Bypass Surgery
The success rates of stomach bypass surgeries are creating a demand for
follow-up cosmetic operations designed to remove excess skin, excise pockets
of localized fat and tighten loose muscle after massive weight loss. This
type of cosmetic or plastic surgery includes such procedures as: tummy
tuck (abdominoplasty), thigh-lift (thighplasty), body-lift (torsoplasty),
belt lipectomy, panniculectomy, breast-lift (mastopexy), male breast reduction
(gynecomastia), arm-lift (brachioplasty), and neck lift (Platysmaplasty).
Liposuction (lipoplasty) is not generally considered to be a weight-related
plastic surgery procedure as this type of suction lipectomy only removes
fat - it does not remove loose skin or tighten loose muscles.
Note: Obesity surgery, whether gastric
bypass or stomach banding, to treat severe clinical obesity is a serious
undertaking requiring detailed consultation with your doctor and bariatric
surgeon.
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