Gastric Bypass Surgery – What You Need to Know

Gastric bypass surgery is considered a convenient and effective
long-term weight loss solution for people diagnosed as morbidly
obese. But because gastric bypass surgery is an elective
procedure, it is imperative that you weigh both the risks and
the benefits before signing on for this life-changing procedure.
This article will explain gastric bypass surgery step-by-step to
help you understand exactly what is involved and make an
informed decision.

Whether you have the open procedure, where they make a long
incision through the outer wall of the abdomen, or the
laparoscopic procedure, where they make several small incisions
for the instruments and special cameras used by the surgeon to
see what he is doing, the steps are still the same. First the
surgeon will use a surgical stapler or hand stitches to divide
the upper stomach into two parts, one large and one small. The
small pouch is about the size of a golf ball and can hold
approximately 20 cc of food (although it will later stretch
some).

This new pouch will still continue to produce the stomach acid
needed to soften and break down your food; however, the small
size dramatically limits the amount of food you can consume
after weight loss surgery. In addition, creating a small pouch
minimizes the risk of developing an ulcer from too much acid
entering the small intestine. (The surgeon could just remove the
lower part of the stomach during gastric bypass surgery, but
they don’t, for a very good reason. It still can produce the
acid needed to digest food, so the operation can be revised, if
necessary.)

Next, the surgeon will divide the small intestine so it can be
directly connected to the new stomach pouch. This part of the
small intestine is called the “Roux Limb” after the Swiss
surgeon who invented the technique. This piece of the small
intestine is connected to the new stomach pouch either using a
surgical stapler or by hand stitching. Even if the surgeon uses
a stapler, he will reinforce the staples at strategic points
with hand-sewn stitches.

After gastric bypass surgery, the food you eat will travel down
the esophagus into the new stomach pouch, where it will briefly
begin to digest. Then, it quickly travels down the new
connection to the small intestine, where it will be joined by
other digestive juices from the lower stomach, liver and
pancreas to complete the digestion process as they travel
together down the length of the small intestine.

In rare cases, the surgeon will insert a tube between the upper
stomach and the intestine to allow stomach juices to flow into
the small intestine. This is only done if the surgeon believes
there is a high probability of a specific complication that
prevents the digestive juices from draining properly. In most
cases, this tube is removed a few weeks after surgery.

Patients generally will stay in the hospital anywhere from two
to six days and will have to eat a pureed diet for many weeks.
Most patients begin losing excess weight immediately and will
lose anywhere from 60% to 80% of their excess weight within a
two year period. Most will keep at least half of their excess
weight off permanently.

Some of the benefits of this type of surgery are that other
illnesses cause by excessive weight–such as sleep apnea, weight
related heart problems, diabetes, and lower back and knee
problems–will greatly improve and may completely disappear.
But, like any surgery, there are risks, some of which can be
fatal. Before considering any type of elective surgery, consult
with your doctor and explore all of the available treatments.

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