Gastric bypass surgery is one of the most effective, but also complex, bariatric procedures available today. At one time, it was the most commonly performed bariatric surgery because of the exceptional weight loss potential it offers as well as the excellent disease resolution results seen in many patients. Today, while it is still a very popular procedure, the gastric sleeve has become the most commonly performed surgery in the United States.
The gastric bypass works in both a restrictive and malabsorptive manner. This means that the amount of food that the patient can eat at any given sitting as well as number of calories absorbed through the small intestine, are limited. Further, the procedure is performed in a minimally invasive manner. Traditional open procedures with large single incisions are not as common, but must be performed occasionally depending on a patient’s particular circumstance.
How It Works
The first part of the gastric bypass involves cutting away about 80 to 85% of the existing stomach pouch. This new stomach pouch is about the size and shape of a golf ball and holds very little food, meaning that patients will be limited in the amount they can eat. The second part of the procedure involves the bypassing a part of the small intestine. The remaining intestinal tract is surgically attached to the smaller stomach pouch. The result is less intestinal surface area through which calories can be absorbed.
The gastric bypass has many benefits including exceptional weight loss and disease resolution potential. This is especially true for those suffering from acid reflux or type-2 diabetes that cannot be controlled through more conservative medical treatments or lifestyle change. A patient’s willingness and ability to change their lifestyle is key to unlocking all the benefits of surgery.
Risks and considerations
Because of the complexity and scope of gastric bypass it does come with several considerations.
- Patients are at risk for nutritional deficiencies. This means that the typical patient will have to supplement their diet with vitamins or minerals for the rest of their lives
- The procedure is intended to be permanent and not easily reversible. In case of a failed procedure, a gastric band can be placed at the top of stomach or an endoscopic procedure can re-shrink the stomach
- Because of the drastic reduction in size of the stomach patients will have to stick to their diet very closely or risk the stretching of the stomach pouch and regaining weight
- The staple line used to seal the cut-away portion of the stomach can leak requiring emergency surgery
- Because the pyloric valve that separates the stomach from the small intestine is cut away during surgery, patients are at a greater risk of experience dumping syndrome, an uncomfortable condition caused by the rapid emptying of stomach contents into the small intestine
Why we do not perform the gastric bypass procedure
Dr. Lublin does not perform the gastric bypass procedure because the results of the gastric sleeve are similar and the post-operative considerations are significantly lessened. Further, over the longer-term, patients have more options to revise the gastric sleeve including adding a band, re-creating the sleeve, or converting to a duodenal switch, then they do after a gastric bypass. We believe that between the gastric sleeve and gastric banding, we can afford most patients the weight loss assistance they need to live a happier and healthier life.