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All you need to know about a gastric bypass

What is a gastric bypass?

Gastric bypass is one of the most common types of weight-loss surgery.

 

The surgery shrinks the size of your stomach by re-routing part of your digestive system so you don't absorb as much food.

 

The procedure is intended for severe obesity patients that are having a hard time losing weight, and it involves creating a small pouch from the stomach and connecting the newly created pouch directly to the small intestine.

 

People that undergo gastric bypass surgery decrease their levels of ghrelin, the so-called hunger hormone, and reduce the risk of weight-related problems like heart disease, sleep apnea, diabetes, stroke, high blood pressure, and arthritis.

Which types of gastric bypass are available?

Roux-en-Y gastric bypass.

 

Reduces the size of your upper stomach to a small pouch, thus reducing the amount of food you can eat.

 

This pouch is directly attached to part of the small intestine called the Roux limb, forming a “ Y” shape, which bypasses the rest of the stomach and the upper part of your small intestine.

 

As a result, this reduces the amount of fat and calories you absorb from the foods you eat, therefore decreasing the number of calories and nutrients you absorb.

 

Extensive gastric bypass (biliopancreatic diversion)

This type of bypass consists of removing the lower part of your stomach and connecting the small pouch that remains directly to the last part of the small intestine.

What are the benefits of a gastric bypass surgery?

Gastric bypass surgery is a long-term life-saving measure, which greatly reduced excess weight and the risks of weight-related health problems, including:

 

  • Heart disease

  • High blood pressure

  • High cholesterol

  • Type 2 diabetes

  • Stroke

  • Infertility

 

A gastric bypass surgery reduces the risk of dying from obesity and other related diseases by 48% for up to 10 years post-surgery.

 

A 2019 study in the journal Diabetologia suggests that gastric bypass can send type 2 diabetes into remission.

What are the risks or possible side effects of gastric bypass surgery?

People who undergo gastric bypass surgery, like any major surgery, are at risk of:

 

  • Pouch stretching

  • Breakdown of staple lines

  • Blood clots

  • Bowel obstruction

  • Low blood sugar (hypoglycemia)

  • Infection

  • Adverse reactions to anesthesia

  • Lung or breathing problems

  • Leaks in your gastrointestinal system

 

Longer-term risks and complications of gastric bypass can include nutritional, vitamin, and mineral deficiencies.

 

Talk with your doctor about making sure you get all the nutrients you need.

How is the gastric bypass surgery like?

Gastric bypass surgery takes a few hours and depending on your recovery, you may stay at the hospital from three to five days after the surgery.

 

The process starts by changing your clothes for a gown and responding to questions to both doctors and nurses.

 

General anesthesia is applied to keep you asleep and comfortable during surgery.

 

Most gastric bypass surgeries are performed by inserting a laparoscope through five or six multiple small incisions in the abdomen.

 

Then the surgeon cuts across the top of your stomach, sealing it off from the rest of your stomach. The resulting pouch changes from three pints of food to hold just an ounce.

 

After, the surgeon cuts the small intestine and sews part of it directly onto the pouch, enabling it to bypass most of your stomach and the first section of your small intestine and directly into the middle part of your small intestine.

 

As a precaution measure, your bariatric surgeon may insert temporary surgical drains from your abdomen, to prevent the buildup of excess fluids.

 

Once the surgery is completed you begin recovery and may have liquids but no solid food as your stomach and intestines begin to heal.

Is gastric bypass surgery safe?

Gastric bypass surgery is one of the safest weight-loss surgeries.

 

Make sure you research and select a board-certified bariatric surgeon for a quality and safe medical treatment.

 

According to the Center for Metabolic and Weight Loss Surgery at Columbia University, “operative complications such as bleeding or intestinal leakage can occur in less than 2% of patients.”

 

Researchers from Cleveland Clinic’s Bariatric and Metabolic Institute reviewed a national database of 66,678 patients with diabetes who had various surgical procedures between 2007 and 2012.

 

The procedures included laparoscopic gallbladder surgery, appendectomy, partial colon resections, hysterectomy, heart surgery, and total knee replacement.

 

The researchers compared the complication and death rates of these procedures to 16,509 patients who had laparoscopic gastric bypass.

 

The month-long death rate for metabolic or diabetes surgery was 0.30 percent (three in every 1,000 diabetic patients), which is about that of total knee replacement and about one-tenth the risk of death after cardiovascular surgery.

 

“The perception has been that the gastric bypass is a very risky operation. But the reality is that it is as safe – if not safer – than many of the most commonly performed surgeries,” says study co-author Ali Aminian, MD, Clinical Scholar of Advanced Metabolic and Diabetes Surgery at Cleveland Clinic.

What should I expect during my gastric bypass recovery?

Gastric bypass patients experience many changes in their body as a reaction to the rapid weight loss in the first three to six months after the procedure, including body aches, dry skin, hair thinning, hair loss, mood changes, sweating, and dumping syndrome.

 

Your doctor will instruct very specific dietary instructions and precautionary information.

 

After gastric bypass, you should evaluate your environment. This includes accessibility to different areas of your home and accommodations in the bathroom.

 

Strenuous activity like heavy lifting, vacuuming, or pushing heavy loads are prohibited for up to six weeks after surgery.

 

Other best practices include avoiding sitting or standing for long periods in order to prevent blood clots, staying hydrated, and taking good care of the wounds. Feeling pain at the incision site or on your neck and shoulder is normal.

How much does gastric bypass surgery costs?

In the Dominican Republic, a gastric bypass surgery ranges between 11,000 and 13,000 thousand dollars for an all-inclusive package that covers the surgery, hospital expenses, lab tests, and transportation. Airfare and insurance are not included in this amount. 

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Bariatric Surgeon

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