North Carolina Gastric Bypass Surgeon Directory

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Gastric Bypass Surgery Information

Definition: Gastric bypass surgery is a procedure which reduces the size of the stomach which is then reconnected so that it bypasses your small intestine. The smaller size stomach forces you to eat less since you will feel "full" much easier. The bypass part of the operation results in few calories and nutrients being stored.

Gastric bypass surgery is not for everyone that is overweight and should not be thought of as quick fix to weight loss. The MayoClinic points this out: "Gastric bypass surgery doesn't replace the need for following a healthy diet and regular physical activity program. In fact, the success of the surgery depends in part on your commitment to following the guidelines given to you about diet and exercise. As you consider weight-loss surgery, make sure that you make every effort to exercise, change your eating habits and adjust any other lifestyle factors that have contributed to your excess weight."

The National Institute of Health that gastric bypass surgery candidates meet the following conditions:

• A body mass index (BMI) of 35 to 40 or higher.
• 100 pounds over your ideal weight.

To calculate your BMI, multiply your weight by 705. Divide the result by your height in inches. Divide by your height again. For example: A 300 pound individual who is 5 foot 8 inches tall would calculate: 300 X 705 = 211500 divided by 68 inches = 3110.294 divided by 68 inches again = a BMI of 45.74

The two most popular and commonly used types of gastric bypass surgery are:

• The Laparoscopic Adjustable Gastric Bypass, and
• The Roux-en-Y Gastric Bypass

The definition of Roux-en-Y Gastric bypass is the same as the above definition. However, the difference between the roux-en Y and laparoscopic adjustable gastric bypass is important to know: Laparoscopic adjustable gastric banding, unlike vertical banded gastroplasty and Roux-en-Y gastric bypass, involves no stapling of the stomach, no cutting or opening of the stomach wall, and no permanent alteration of the gastrointestinal (GI) tract. Should it be necessary to remove the band, normal stomach anatomy can be restored.

How well does it work and what are the results?

1. During the first two years following your gastric bypass surgery, you should be able to lose 50 to 60 percent of your excess weight. You will begin to lose weight not long after your surgery and continue to lose much of your weight during the first 12 months. Many patients report losing up to 100 lbs during the first 18 months following the procedure. Due to the nature of the procedure, you will have to follow a special diet. This diet should help you to keep the weight off.

2. Significant weight loss can make it easier to manage medical problems such as:

• Type 2 Diabetes
• High cholesterol
• High blood pressure
• Sleep apnea
• Hypertension
• Coronary artery Disease
• and gastroesophageal reflux disease (GERD)

Roux-en-Y gastric bypass has demonstrated the best ratio of results to complications among bariatric procedures, giving it status as the "gold standard" in bariatric surgery. The benefits include:

• better long-term weight loss,
• fewer complications and less need for revisions,
• better lifestyle with less vomiting, and
• good reflux control because the majority of the parietal cell mass and bile are barricaded from the esophagus.
• return of blood sugar levels to normal in 90% of patients;
• decreased hypertension (ie, disappearing in two-thirds of patients);
• diminished knee and hip pain;
• disappearance of sleep apnea, often after a weight loss of only 15 kg to 20 kg;
• relief of esophagogastric reflux symptoms, often within 24 hours of surgery;
• improved pulmonary function;
• slower progression of articular cartilage destruction;
• improved serum concentrations of high-density lipoproteins;
• substantial decline in total serum cholesterol and triglyceride levels;
• relief of stress incontinence; and
• the patient becomes a good candidate for joint replacement when he or she previously was too heavy.

What can you expect after the surgery?

After your procedure, you will need to stay in the hospital for 2 to 3 days and will not be able to return to work for 2 to 4 weeks.

Immediately after your procedure, you won't be allowed to eat for one or two days so that your new and smaller stomach can heal. Then, you will have to follow a diet that progress from liquids to pureed food to soft foods and finally to regular foods. Besides a diet, exercise is also recommended.

Since part of your intestine was bypassed and you are no longer absorbing nutrients the same, you will need to take iron and vitamin suppliments.

One aspect of gastric bypass surgery that doctors rarely mention is that in a few years, you might need plastic surgery in the form of abdominoplasty. Abdominoplasty removes the loose folds of skin around the stomach brought on by the fast weight loss.

Risks

As with any surgery, gastric bypass surgery is not without it's risks.

• Death from the surgery or complications following the surgery occur 1 to 2 percent of the time. Chances of death following surgery are reduced if the doctors post operation instructions are carefully followed.
• More than one-third of obese patients who have weight loss surgery develop gallstones. Gallstones are clumps of cholesterol and other matter that form in the gallbladder. During rapid or substantial weight loss, a person’s risk of developing gallstones increases. Gallstone formation can be lessened with medication taken for the first six months after surgery.
• Among other surgery risks, nearly 30% of patients who have weight-loss surgery develop nutritional deficiencies such as anemia, osteoporosis and metabolic bone disease.  These deficiencies can be avoided if vitamin and mineral supplements are maintained as recommended on a life-long basis.
• The connection between the stomach and the intestines narrows (stomal stenosis) 5% to 15% of the time, leading to nausea and vomiting after eating.
• Ulcers develop 5% to 15% of the time.
• The staples may pull loose.
• Gastric bypass can also cause dumping syndrome, a condition where stomach contents move too quickly through the small intestine causing nausea, vomiting, diarrhea, dizziness and sweating.