Step1:
Four or Five thumb sized working tubes are inserted into the abdomen.
Step2:
A special surgical stapler is used to divide the upper portion of the stomach from the lower portion of the stomach into a golf ball sized pouch.
Step3:
The first portion of the small intestine is divided, tunneled behind the remnant stomach and attached to the new pouch with a dime sized opening. This allows food to bypass the remainder of the stomach.
Step4:
The divided portion of the upper small bowel in reconnected to the lower small bowel using a surgical stapler.
According to two organizations, the American Society for Bariatric Surgery and the National Institutes of Health, Roux-en-Y (pronounced ROO-en-why) gastric bypass surgery is the “gold standard” and most performed bariatric surgery in the United States.
In this procedure, the surgeon creates a small stomach pouch and then constructs a “bypass” for food. The bypass allows food to skip parts of the small intestine. By skipping a portion of the small intestine, the body cannot absorb as many calories or nutrients.
Advantages of the Laparoscopic Gastric Bypass
85 percent of type 2 diabetes cases are resolved. This often occurs within days of gastric bypass surgery.
Hypertension is improved in the majority of patients and is resolved in 92 percent of patients
97 percent of cases of hyperlipidemia are resolved
98 percent of cases of Gastroesophageal Reflux Disease are resolved.
75 percent of patients with Sleep Apnea show resolution.
On average, 75 percent of the excess body weight is lost over the first two year period.
In 2000, a study of 500 patients showed that 96 percent of co-morbidities (the study looked specifically at back pain, sleep apnea, high blood pressure, type 2 diabetes, and depression) were improved or resolved.
The average excess weight loss after a gastric bypass procedure is generally higher than with a purely restrictive procedure.
As with every type of bariatric surgery, compliance with a well rounded program can lead to significant loss of excess body weight and an overall improvement in the quality of life.
Risks and Disadvantages
Because the duodenum and first portion of the jejunum are bypassed, poor absorption of iron, calcium and the acid soluble vitamins and minerals can occur. This can cause low total body iron and a greater chance of having iron-deficiency anemia. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the possibility of increased bone calcium loss. By taking multivitamin, calcium supplements and B12 replacements, patients can maintain a healthy level of minerals and vitamins.
A condition known as dumping syndrome can occur from eating too much sugar or large amounts of carbohydrates. While it isn’t considered a serious health risk, the sensation can be very unpleasant. Symptoms can include vomiting, nausea, weakness, sweating, faintness, and, on occasion, diarrhea.
Due to the small size of the pouch, food choices need to be carefully reviewed with the dietician. You will progress through five stages of diet with a focus on the intake of protein based calories. This will help prevent hair loss and loss of lean muscle mass.
