Gastric Bypass Surgery

Explore The Bariatric Skinny for informative content on gastric bypass surgery. Learn about the Roux-en-Y gastric bypass, biliopancreatic diversion with duodenal switch procedure and more.

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Gastric Bypass Surgery Overview

Gastric bypass, a common type of weight loss surgery, physically reduces food intake for patients who have tried and failed to lose weight through regular diet and exercise. The procedure combines both restrictive and malabsorptive techniques to create a small stomach pouch and bypass the larger part of the stomach and duodenum. This stomach-shrinking process significantly limits food intake so that patients feel much fuller with less food. Food no longer goes into some parts of the stomach and small intestine that normally break down food which decreases the body’s ability to absorb calories and nutrients. Good candidates for gastric bypass surgery are generally patients approximately 75 pounds overweight with obesity-related health problems, such as Type 2 diabetes, or 100 pounds overweight without any other complications. Patients spend one to two days in the hospital for the laparoscopic procedure. Patients average two to five weeks of recovery time before returning to normal activities. Aftercare includes a strict diet regimen, regular exercise, and vitamin supplements. There are short-term as well as long-term health risks. Post gastric bypass, patients may experience anesthesia complications, infection, or bowel obstruction. Long-term risks include nutritional deficiencies, weight regain, or gastro-esophageal reflux disease.

Types of Gastric Bypass Surgery

Roux-en-Y Gastric Bypass

The Roux-en-Y gastric bypass is the most common gastric bypass procedure, and offers a good balance between weight loss and complication risk. In this process, a surgeon creates a small stomach pouch by stapling, or banding, part of the stomach together. Then, a Y-shaped portion of the small intestine is attached to the pouch bypassing the duodenum and part of the jejunum. The patient’s new, restricted stomach becomes too small to hold large amounts of food. This process results in an alteration of the digestion process which substantially reduces calorie, nutrient, and fat absorption. The procedure may be performed as standard open surgery, but is now more frequently done as laparoscopic surgery. The minimally invasive, laparoscopic approach involves very small incisions resulting in less pain and a speedier recovery. The Roux-en-Y surgery gets its name from César Roux, the Swiss surgeon who is credited with origination of the procedure.

Extensive Gastric Bypass – Biliopancreatic Diversion

Extensive gastric bypass surgery is more complicated, and less frequently performed, than Roux-en-Y. There are two types of extensive gastric bypass: biliopancreatic diversion and biliopancreatic diversion with duodenal switch. In biliopancreatic diversion, a surgeon removes the lower portion of the stomach. The remaining, smaller stomach is then connected directly to the final portion of the small intestine bypassing the duodenum and the jejunum. In biliopancreatic diversion with a duodenal switch, a different part of the stomach is removed leaving a larger portion of the stomach intact. The intact portion includes the pyloric value which regulates food drainage into the small intestine. Most doctors do not recommend the duodenal switch unless patients are severely obese (BMI over 50) with serious health problems. With these more invasive bypass surgeries, patients are at a higher risk for nutritional deficiencies. Prescriptions for dietary supplements and multi-vitamins accompany extensive gastric bypass surgery as part of lifelong aftercare.

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The Dr's program shows Tera's journey from obesity to gastric sleeve surgery.  Tera's body weight hit 233 lbs and health risks, such as diabetes, were threatening her long term health.  Concerned about obesity-related health risks and wanting to be there for her grandchildren for years to come, she decided to undergo gastric sleeve surgery. Bariatric surgeon Dr. Brian Quebbemen performed the gastric sleeve procedure using the SPIDER Surgical System developed by TransEnterix. The SPIDER System allowed Dr. Quebbemen to access Tera's abdomen through one small incision…

From the Bariatric Surgery Journals

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