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Laparoscopic Gastric Bypass

The gastric bypass is the oldest and best studied bariatric procedure in the United States. A small gastric pouch is created, accounting for the restriction while the Roux limb and the bypassed stomach and bowel account for the malabsorption. The average weight loss is about 1 lb a day for the first 3 to 4 months.

It is a very powerful treatment for diabetes and has been shown to be able to cure type II diabetes in up to 80% of patients providing their pancreas has not been permanently damaged by longstanding diabetes.

Gastric Bypass

The main advantages of the gastric bypass are:

  1. It is a very effective treatment for diabetes.
  2. Early satiety and some malabsorption contribute to fast and durable weight loss.
  3. Excellent long term weight loss results, averaging 60-75% of excess weight.
  4. Risk of major complications is less than 1% among experienced fellowship trained surgeons.

The gastric bypass operation is performed laparoscopically and results in reduced pain and better and smaller scars.

gastric bypass operation     post gastric bypass operation

The laparoscopic approach to gastric bypass results in lower risk of wound infections and wound hernias.

Side effects and Complications
Leaks occur in approximately 1 out of 300 patients along the sites where bowel have been joined together. This usually occurs within the first 7 days of surgery. This could make the patient very ill and may result in the need for additional procedures. Though uncommon, some patients may die from a leak. In order to reduce the consequences of a leak, our program as well as other experienced programs, places a small drain at the site of the bowel join. The drain is removed during your office visit in the first week after surgery.

Internal hernias causing bowel obstruction may occur in 1 out of a hundred patients, typically at 18 months to two years after surgery. This would cause severe abdominal pain but can also present as intermittent episodes of cramping abdominal pain. This is a complication that would need the urgent attention of a bariatric surgeon.

Marginal ulcers occur at the site of the join between the Roux limb and the gastric pouch. They cause pain after meals and may cause excess weight loss, bleeding or in some cases perforation. It is more common in people who smoke, use aspirin, motrin or related medications called non-steroidal anti-inflamatory medicines (NSAIDs).

Nutritional deficiencies: These can arise if a patient is not compliant with nutritional guidelines after gastric bypass. Failure to take supplements for calcium, iron and B12 may lead to deficiency of these items. Not paying attention to protein intake could also lead to protein malnutrition in a small proportion of patients.

Blood clots can complicate any surgery or hospital admission. The very obese are at added risk of leg clots after surgery. We take many precautions to prevent this complication. During the preoperative evaluation, patients at increased risk identified and given a higher level of preventive medications. Preventive measures include use of heparin injections, calf compression devices and getting out of bed and walking on the evening of surgery.