What is a 'Gastric bypass surgery'?
Gastric bypass surgery is one of the surgical procedures carried out in the treatment of morbid obesity or the unresponsive obesity. It will drastically reduce the amount of food a person can eat and thus alter the eating habits associated with the disease. It has shown remarkable results in reducing the weight of such patients and as with any other major surgery it does possess life threatening complications as well.
What are the indications for Gastric Bypass?
The decision to undergo gastric bypass surgery will be decided upon few factors. The Body Mass Index (BMI) and other co-morbid factors are considered the two most important indications. Usually, the surgeons will decide on proceeding with a gastric bypass in patients who has a BMI of more than 40 or patients with a BMI of over 35 with other co-morbid factors such as diabetes, hypercholestrolaemia, hypertension, venous disease..etc.
What are the different approached in doing the surgery?
The surgeons will decide on the approach to the surgery based on the patient and it will be either open surgery or laparoscopic surgery. In both instances the surgical procedure will be the same, but in the latter, the hospital stay will be reduced as well as some of the complications.
How will the surgery be done?
Prior to the procedure, the patient will be given general anaesthesia. The basic idea of the surgical procedure is to reduce the volume of the stomach as well as to reduce the length of effective absorption in the small intestine.
The process will see different approaches by different surgeons, but the most commonly practiced procedure is the 'Proximal Roux-en-Y' bypass.
In this procedure, the stomach will be divided at its upper segment into a much smaller proximal pouch and a larger distal pouch. The proximal pouch will be in continuity with the oesophagus. The proximal end of the larger portion of the stomach will be sealed off. The small intestine will be divided at the proximal end of the jejunum. The proximal end of the jejunum will now be attached to the distal end of the smaller gastric pouch which is in continuity with the oesophagus. This will effectively bypass a larger portion of the stomach as well as the absorptive areas of the small intestines. The blindly ending larger portion of the stomach which continues into the smaller intestines will now be inserted to the proximal jejunum using a 'Y' formation.
What will be the outcome of the surgery?
Following the surgery the blind ended larger portion of the stomach will continue to produce gastric juices and will secrete it to the proximal jejunum where the most of the digestion is taking place. The small sized stomach pouch will prevent the patient from eating even a handful and will reduce the amount of calories absorbed as well.
After the surgery, which can take up to 4 hours, a tube will be in place in the stomach through the mouth and another to the blindly ending stomach pouch which comes out through the abdominal wall.
How does the patient recover following the surgery?
The recovery of the gastric wound will take several days and the patient will have to be on fasting for 2-3 days and gradually introduced to taking liquids.