Gastric Bypass Surgery
LAP BAND and Gastric Bypass Surgery are the common types of weight loss surgery for the treatment of obesity. Both types involve gastric banding, which reduces the stomach size to reduce hunger. This article is about gastric bypass surgery.
Gastric bypass surgery is a type of weight loss surgery used to treat patients who are 100 pounds over weight or who have a BMI in excess of 40. It uses a technique known as gastric banding, which reduces the size of the stomach. Gastric bypass was introduced more than 35 years ago. About half of gastric bypass operations are performed through open surgery, which requires a long incision to the abdomen. The other half, like LAP BAND, are performed using laparoscopic surgery.
Gastric bypass involves a stapling device that cuts and separates a small piece of the stomach (known as the "pouch") from the rest of the stomach. The pouch becomes a new stomach and the rest is closed off on permanently. Depending on the procedure, the pouch is then connected either to the middle of the small intestine (jejunum), "bypassing" the upper portion (duodenum), or further down at the distal ileum. This bypass allows the newly-created, smaller stomach to pass food further downstream so that the digestive juices from the liver, gallbladder, and pancreas are included in the digestion process. In a final step, the surgeon sometimes connects the jejunum to the duodenum so that its digestive juices can contribute as well.
By bypassing sections of the stomach and small intestine, gastric bypass surgery has the effect of reducing hunger and, unlike LAP Band surgery, also reducing absorption of nutrients and calories. This combination of effects contributes to the weight loss that occurs after surgery.
Gastric Bypass Procedures: Roux-en-Y and Biliopancreatic Diversion
There are two main versions of gastric bypass surgery: Roux-en-Y and Biliopancreatic Diversion. Rou-en-Y gastric bypass surgery comes in two forms: the traditional procedure, which is performed via a long incision in the abdomen, and laparoscopic, which uses a camera (laparoscope) so that smaller incisions can be made. In Rou-en-Y gastric bypass surgery, the newly-formed pouch is connected to the middle of the small intestine (jejunum), which allows more nutrients and calories to be absorbed. In contrast, the Biliopancreatic Diversion procedure attaches the pouch to a section of intestine that is located further down, thereby severely restricting absorption of nutrients and calories. Biliopancreatic Diversion is a very complicated procedure that can lead to serious complications in some cases. As result, this procedure is rarely used in the U.S.
Potential Complications of Gastric Bypass Surgery
Gastric bypass is a major surgical procedure with a risk of serious complications or even death (mortality rate: approximately 1%). It causes significant changes in the digestive tract and is fundamentally irreversible. To learn about the risks involved with gastric bypass and see how they compare to those for LAP BAND surgery, visit the LAP Band Versus Gastric Bypass page of the True Results website.
Recovery from Gastric Bypass
After surgery, most patients remain in the hospital for one to three days, depending on outcome and the procedure performed. Several weeks of additional, at-home recovery are also necessary. Because gastric bypass surgery causes abdominal swelling, most patients feel very sore in the initial days following the procedure. Gastric bypass surgery also leaves a scar. The scars for LAP Band surgery are typically less noticeable than with gastric bypass.
Most surgeons who perform gastric bypass surgery, LAP BAND, or other types of weight loss surgery give their patients a dietary plan following surgery. Patients are also instructed to exercise consistently.