Gastric Bypass Surgery

Gastric bypass, also known as Roux-en-Y gastric bypass, is a type of weight loss surgery, which involves creating a small pouch at the top of the stomach and connecting that pouch with the small intestine, bypassing the rest of the stomach. This results in the patient needing less food intake leading to a reduced calorie intake.

Gastric bypass surgery is a very common bariatric surgery that helps lose excess weight by changing the way the stomach and intestine handle and absorb the food consumed. Food will bypass some parts of the stomach and part of the small intestine that usually absorb the food. Therefore, the body will not absorb all the calories that are consumed due to there being less surface area for the absorption of calories.

Patients undergoing a gastric bypass should be willing to adjust to permanent lifestyle changes. In addition, the patient will possibly be required to follow up on long-term plans that monitor their medical health condition, nutrition, and general lifestyle.

Who would need a Gastric Bypass?

Gastric bypass is a surgical solution for weight loss for those who are obese or dealing with weight-related health problems that can be life-threatening. A gastric bypass surgery will be considered after the patient has already tried losing weight by improving their eating and exercise habits.

A gastric bypass surgery could be an option for people who are obese with a body mass index (BMI) higher than 40. A BMI of 35 and above indicates that the person is considered overweight and is dealing with obesity-related health problems, thus might qualify for certain bariatric surgeries.

Gastric bypass surgery is done to aid weight loss but can also reduce the risk of other obesity-related health conditions, such as:

• Heart disease
• High blood pressure
• High cholesterol
• Gastroesophageal reflux disease
• Obstructive sleep apnea
• Diabetes Type 2
• Cancer
• Stroke
• Infertility

How to prepare for a Gastric Bypass procedure?

A few weeks before having the gastric bypass surgery, the patient will be consulted by the bariatric surgeon and dietician on how to prepare for the operation.

The specialists will likely suggest following a strict diet, starting a physical exercise program, and quitting smoking (if this applies). The doctor will also need to know if the patient is taking any medication, which may need to be stopped prior to the surgery.

What to expect from a Gastric Bypass procedure?

During the Procedure

The surgery will be performed laparoscopically, which involves inserting surgical instruments through several small incisions in the abdomen. The surgery will be also done under general anaesthesia. The surgery is divided into 2 steps:

• In the first step, the surgeon uses a laparoscope (long, thin endoscope with a camera lens), that is inserted through the small incisions (4 to 6 small cuts) into the stomach to make the stomach smaller. The surgeon uses surgical staples to divide the stomach into a small upper section (known as the pouch) and a larger lower section. The pouch is a small, walnut-shaped section of the stomach that holds about an ounce (oz) or 28 grams (g) of food.

• In the second step, the surgeon cuts a part of the small intestine and connects it to the pouch through a small hole on it. The food will now pass from the pouch to this new hole and then directly through the small intestine. This way, the body will absorb fewer calories from the food.

The surgery takes about 2-4 hours, and the patient should be able to go home the day after the procedure.

After the procedure

Straight after the surgery, the patient will be closely monitored by the doctors/nurses to assess their physical state and identify any complications. Appropriate medication, such as painkillers, will be given by the doctor to relieve any post-operation pain.

After the surgery, the patient will be able to drink only clear fluids, following a liquid diet (including soft, moist food and soups) and after 2-3 weeks the patient can start eating firmer food if the body can tolerate it. For several weeks after the surgery, the patient might be restricted on how much they are able to eat or drink and will be recommended to take vitamin and mineral supplements.

Several side effects that might be experienced in the first three to six months post-surgery include:

• Bleeding, blood clots or wound infection
• Nausea and vomiting
• Burning feeling in the stomach (gastritis)
• Body aches
• Feeling tired
• Hair loss or thinning
• Dry skin
• Mood swings

Results

Gastric bypass patients are promised successful weight loss results, 70% or more of excess weight is seen to be lost, in about nine to twelve months after having the operation.

Apart from achieving long-term sustainable weight loss, gastric bypass improves the patient’s daily activities and quality of life.

What are the benefits of Gastric Bypass?

A gastric bypass surgery benefits people dealing with obesity health problems by improving their health and lifestyle dramatically. The benefits of having a gastric bypass operation can be both physical and mental, these include:

• Long-term weight loss
• Absorption of fewer calories from food
• Improved and stabilized BMI
• Healthier lifestyle
• Joints and lower back pain relief
• Increased mobility
• Increased self-esteem
• Relief of Gastroesophageal reflux disorder symptoms
• Improvement of obesity-related health conditions (such as heart disease, high blood pressure, diabetes type 2, high cholesterol, sleep obstructive apnea or stoke)

What are the complications of Gastric Bypass?

As with any surgical procedure, gastric bypass has several possible complications including:

• Damage to organs
• Hernia near the surgical cuts or inside the abdomen
• Surgical emphysema
• Pouch stenosis
• Wound bleeding
• Ulcers
• Diarrhoea
• Nutritional deficiencies
• Low blood sugar
• Anastomotic leak (stitches between the pouch and small intestine – start leaking)
• Developing gallstones – stones formed near the gallbladder

What is the cost of a Gastric Bypass surgery?

The typical cost of gastric bypass, in private clinics in the UK, is approximately £8,000 to £15,000. This price usually includes the medications and aftercare, but this will depend on the clinic you choose.

Bariatric surgeries, including gastric bypass, are available on the NHS, but only for those whose obesity is life-threatening and have already tried non-surgical solutions that were not successful.