Gastric Bypass , one of the most promising type of bariatric surgery, is a combination of both restriction and malabsorption. With the help of staplers, a new and small stomach pouch is created. It is then attached to the intestines in such a manner so that food bypasses a limited, well defined length of intestine.
How gastric bypass works
The new stomach is only 20-30 ml in size. Hence, a very limited quantity of food can be consumed at a given point of time. The gastric bypass therefore gives a good restrictive component.
In addition, the new stomach is attached to the intestine in such a manner that about 20% or 150 cm of intestine is bypassed. This means the food does not travel in this bypass part of intestine. Hence, limited absorption of calories and minerals takes place, thereby making it one of the most effective weight loss procedure.
Gastric bypass surgery produces hormonal changes in body which causes decreased appetite.
Hormonal changes also improves the metabolism of sugar or glucose. As a result, diabetes is completely cured in majority of the patients within few days.
Positives of gastric bypass
Though weight loss may almost be similar to sleeve gastrectomy but this procedure has better control of co-morbidities as compared to sleeve gastrectomy
- Hypertension, lipid disorders, diabetes, obstructive sleep apnea, GERD, and asthma either are resolved or improved in 90% to 100% of patients.
- Arthritis, back or extremity pain, and depression improve in 72% to 85% of patients.
- Quality of life improves for over 90% of patients.
Other health problems that are improved following surgery:
- Leaking of urine especially in females (stress incontinence)
- Certain types of headaches
- Cholesterol disorders
- Fatty liver
How long does the procedure take?
Gastric Bypass is done through laparoscopic or key hole surgery and generally takes an an hour and a half to perform.
How long will be the scars?
The procedure involves making 4 or 5 small cuts ranging from 5 mm to 10 mm long in the abdomen.
How does the patient feel following surgery?
Patient are able to walk around your private room within hours of surgery. There is minimal pain or discomfort which is well controlled with soluble painkillers.
How long the patient stays in hospital?
Some patients will be keen to go home the day after surgery but most will prefer to stay and relax in the hospital and return home after the second night.
How long the patient need off work?
One or two weeks depending upon the nature of your job.
After how much time the patient can exercise?
We encourage the patient to walk around within hours of surgery. The morning after surgery we would expect our patient to walk around relatively comfortably. On discharge from hospital we recommend increasing activity levels on a daily basis under the constant guidance of our physiotherapists. More active exercise such as at the gym can be introduced one week after surgery, with a gentle reintroduction to aerobic exercise such as light jogging, cycling or swimming.Any exercise involving heavy lifting can be started after one month.
What is diet after bariatric surgery?
Our dedicated bariatric nutritionists will continuously help you in your weight loss journey. Depending upon the patients eating preferences, our nutritionists will make a customized diet plan to ensure comfortable recovery.Following surgery a liquid diet should be maintained for one week. This should be followed by a diet of pureed consistency food for one week. The third week should consist of mashed consistency foods and thereafter a slow introduction of well chewed solid foods.
What will eating be like in long term?
Following a gastric bypass after the initial month where solid food is reintroduced, eating becomes much easier. Within two or three months you will be able to contemplate eating out. Clearly the amount of food will be much less and a starter portion will usually suffice, however patients report that the quality of life, as far as eating is concerned following a gastric bypass, is back to normal within a few months of surgery.
Does the appetite change?
Gastric bypass significantly reduces the appetite. It produces hormonal changes, which dodges the brain and brain starts sending signals of satiety even after a small amount of meal. Eating a small amount of food will give pleasant feeling of fullness for hours and many patients will have to remind themselves to have lunch by setting a reminder alarm. The changes of appetite tend to last for at least twelve to eighteen months and in many cases for a longer term. In addition to this, most patients develop an aversion to sweet foods and also to foods in high fat content.
What to do to ensure long term weight loss?
The gastric bypass is one of the extremely effective procedure in producing weight loss and for resolution of diseases associated with obesity.However it should not be considered a magic wand and it is vital for patient to changes their lifestyle as advised to help maintain this weight loss for the years to come.This would include changing their eating pattern as advised by our bariatric nutritionist, cutting down of unhealthy high calorie foods and finally the introduction of a more active lifestyle. These changes should ensure a sustained, long term weight loss.