Procedure for Gastric Bypass

Gastric Bypass

Gastric in medical terminology means pertaining to the stomach. Gastric bypass surgery is a procedure to reduce the size of the stomach by dividing it into two halves and reconnecting the small intestine to the smaller part of the stomach, thus bypassing a major part of the stomach. It is performed mainly for weight loss (such surgeries are known as bariatric surgeries).

Types of Bariatric Surgeries

1. Roux-en-Y gastric bypass: Is one type of gastric bypass surgery where only a very small part of stomach is used to form a new stomach pouch, the large part is bypassed and connected to the second part of the small intestine.
2. Gastric band: Here the surgeon ties a small band on the upper part of the stomach thus reducing the size of the stomach.
3. Gastric sleeve: Is a more recent type of bariatric surgery where in a major portion of the stomach is removed, leaving only about a tenth of a portion of the stomach.

Indications

Weight loss being the main indication wherein the below given conditions exist:

• Body mass index of 40 and above.
• Body mass index of 35 to 40 associated with other diseases such as Type 2 diabetes, lipid disorders, hypertension, diseases of the stomach and small intestines, sleep apnea, etc.

Procedure

The Gastric Bypass surgery can be performed in following ways. The surgeon will decide on the type of procedure based on the patient’s condition, age and requirement.

• Open method (where a large incision on the abdomen is taken).
• In laparoscopic method, small incisions (4-5) are made.
• Both type of surgeries are done under general anesthesia.
• Options for both procedures have to be discussed before the surgery, since both have different advantages.
• Through laparoscopic small incisions, instruments and a camera are placed. After the steps for the selected procedure are done, these sites are sutured.

Advantages and Disadvantages of Each Procedure

Apart from other general surgical complication risks like bleeding, infection; following is the list for each procedure:

• Roux-en-Y Gastric Bypass:
  1. Very widely done
  2. More rigorous weight loss after surgery
  3. Minimal portion of food intake required and there is minimal hunger.
  4. Disadvantage is if slightly more food is consumed patient experiences abdominal pain and diarrhea (dumping syndrome).
  5. More follow-ups are required and strict adherence to diet plan is required.
  6. Malabsorption (vitamin deficiencies and more weight loss).

• Gastric Band:
  1. Surgery takes lesser time as the procedure is small.
  2. No dumping syndrome
  3. Vitamins are absorbed properly.
  4. Considered safest of the bariatric surgeries
  5. Disadvantage here again being more follow ups for band adjustment.
  6. To achieve adequate weight loss good diet and habit change is required.

• Gastric Sleeve:
  1. Weight loss is rapid.
  2. Generally, all type of foods can be consumed in very small quantities.
  3. Main disadvantage here being leak from the sleeve, which can take months to heal.
  4. One of the more recent types of bariatric surgery hence long-term complications are still unknown.