Gastric
bypass surgery - Banding
Gastric bypass surgery, or simply gastric
bypass surgery, is a procedure almost exclusively used
in surgical weight-loss applications to correct morbid
obesity.
Indications
Gastric bypass surgery is recommended only for patients
who are morbidly obese, usually more than 100 pounds
(45 kg) overweight. These individuals have major health
problems related to their weight. The Body Mass Index
BMI is typically used to identify surgery candidates
with a cut-off of 40 being used by most surgeons. BMIs
down to 35 are typically permitted if the individual
has other serious health issues.
Procedure
The procedure involves stomach stapling to reduce the
stomach to a "pouch" of 30-60 mL (1–2
fl. oz.) in capacity and connecting this pouch at a
point midway along the small intestine. The larger portion
of the stomach is left in the body and is connected
to the small intestine further down, in order to allow
the introduction of gastric juices that are essential
for digestion. The surgery varies in length and can
be performed through a 6–8 inch vertical incision
in the abdomen or through a number of small incisions
(see laparoscopic surgery).
Gastric bypass surgery has two main results: the tiny
stomach pouch means that the patient is able to eat
only very small portions of food at a time, drastically
reducing intake of calories; and the shortened digestive
tract prevents those calories from being fully absorbed.
This is why gastric bypass surgery is classified as
both a restrictive (reducing intake) and malabsorptive
(reducing absorption) procedure.
Post-Surgery Expectations
The length of hospital stay after the surgery varies,
but usually lasts 2–7 nights. Gastric bypass is
overwhelmingly successful, with many patients losing
over 100 pounds within the first 18 months following
surgery. Gastric bypass surgery should always be accompanied
by an exercise regimen.
Undergoing a gastric bypass requires patients to commit
to a new lifestyle. They will no longer be able to eat
large portions of food at one sitting, nor will they
be able to eat foods high in sugar or fat, which often
result in dumping syndrome, an unpleasant feeling of
faintness caused by the sudden absorption of these foods
in the shortened digestive tract. Due to the limited
amount patients can take in at any one time, they must
constantly drink small amounts of water or risk dehydration.
Risks
The operation has a morbidity rate of approximately
2% overall--1% suffer immediate complications and death;
another 1% will commonly have post-operative complications
that lead to death within one month of surgery. This
can be mitigated by compliance with the surgeon's post-operative
plan and using a doctor who has performed more than
200 procedures.
A full 25% of people undergoing this operation will
have some form of post-operative complication either
requiring a further procedure or change in habits. In
some instances, the production of an intrinsic factor
in the stomach wall to aid in vitamin B12 absorption
is decreased. This may call for B12 shots for life to
aid in the breakdown of food for energy.
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