Obesity Surgery - Laparoscopic (minimally invasive) Gastric Bypass
This surgery involves creating a small 20 cubic centimetre, thumb sized stomach pouch, as well as a bypass of most of the stomach and a varying amount of small intestine. As a result, weight loss is accomplished both by restriction of food and by malabsorption of nutrients. Many people report diminished appetite after this type of surgery, known as a Roux-en-Y (RNY) gastric bypass, as well as a change in the taste of food.
Roux en Y gastric bypass interferes with the normal digestion of food. This is so because the digestive enzymes normally produced in the stomach, liver, pancreas and upper small intestine continue to be made, but do not contact the food that has been ingested until a few feet down the intestine. Hence, the digestion of the food is delayed until it is already part way down the intestine.
These are additional ways the gastric bypass causes weight loss.
Advantages of Laparoscopic (minimally invasive) Gastric Bypass method
The advantages of performing the gastric bypass laparoscopically are that recovery is faster, and cosmetically, the results are better. Some long-term problems, such as incisional hernias, also occur less frequently. Sometimes previous abdominal surgeries make the laparoscopic technique difficult or impossible, because of adhesions (scarring), so the open procedure may have to be resorted. The Roux-en-Y gastric bypass routinely necessitates a stay of 3-5 days in the hospital. Risks
1. Following RNY surgery, patients are at risk of developing anaemia because of poor absorption of iron and vitamin B12. Therefore, dietary supplementation of these nutrients is required. Poor absorption of calcium may also occur. Thus, calcium supplements must also be taken postoperatively and exercises are important to prevent bone demineralisation.
2. Since the staples at the top of the stomach completely block off the lower portion of the stomach and the upper small intestine, there is no easy way to evaluate these portions of the gastrointestinal tract should a problem -- such as ulcer, bile duct stones, or cancer -- arise at a future time. In fact, although this could be a very real problem, it seldom becomes an issue.
3. Ingestion of concentrated sugar is also essentially prohibited because doing so results in "dumping." Dumping is a group of unpleasant symptoms that resembles food poisoning (nausea, vomiting, diarrhoea, abdominal cramps, flushing/sweating, and palpitations) that occurs when simple sugars enter the small intestine in high concentration.
Weight loss commonly reaches 70% of a person's excess body weight. As in all weight loss surgery, however, the amount of weight loss is not guaranteed. The amount of weight a patient loses depends not only upon the surgery, but also upon what the patient does with the surgery. The surgery is not a cure for morbid obesity; it is merely a tool. Patients have been known to ingest large quantities of high caloric foods that can result in less than satisfactory weight loss. If a patient adheres to the diet, and if exercise becomes a part of the patient's regular routine, a substantial weight loss usually results.
Benefits After losing this amount of weight, patients usually feel physically and mentally better. Preoperative comorbidities such as diabetes, hypertension, stress incontinence, back pain, knee pain, heel pain, sleep apnoea and other complications of obesity are usually either improved or eliminated altogether.
