Gastric bypass

Gastric Bypass is a surgical procedure used in the treatment of obesity. Obesity is a serious, chronic disease that is growing worldwide concern affecting the healt of millions of peole. Obesity is defined as an exessively high amount of body fat in relation to learn body mass resulting from caloric intake that exeeds energy usage. Obesity is the second leading cause of preventable death following smoking. Compared to peole of normal weight, obese peole have a 50 – 100% increased risk of dying prematurely.

Potentially life-threatening obesity is defined as:

> having a body mass index (BMI) of 40 or above
> having a BMI of 35 or above and having another serious health condition that could be improved if you lose weight, such as type 2 diabetes or high blood pressure

Gastric Bypass surgery is a combined ( restrictive and malabsorptive) surgical procedure. It is restrictive in the senise that it „restricts“ how much food the stomach can hold and is „malabsorptive in a way that it affects how food and calories are absorbed into the bloodstream from small intestine. This combination surgery is highly effective in achieving weight loss. On average, patients lose 60% of their extra weight.

The most common gastric bypass surgery is Roux -en-Y.

This operation is done laparoscopically (keyhole surgery), exept in case of a complication. In this surgery, the surgeon creates a small stomach pouch by stapling the upper part of the stomach (15 – 30 ml). A new opening from this pouch is created as well. The small intestine is then cut into two sections. The lower section of intestine is attached to the opening in the stomach pouch creating what is referred to as the „roux limb“. The upper section of the small intestine which carries digestive juices from the remaining portion of the roux limb. The roux limb enables food to bypass the lower stomach, duodenum, and a portion of the small intestine.

Advantages of Gastric Bypass surgery include:

• quick and dramatic weight loss
• continued weight loss for 18 – 24 months post surgery
• many patients maintain a weight loss of 60 – 70 % of excess weight 10 years post-op
• improved healt problems associated with severe obesity (ie. diabetes, high blood pressure, sleep apnea etc.)
• Improved mobility and quality of life

Disadvantages of Gastric Bypass surgery include:

• major surgery with serious risks
• malnourishment and anemia may occure requiring life long vitamiin and mineraal supplementation
• requires permanent lifelong hanges to patient`s diet and lifestyle
• increased risk of gallstones due to rapid weight loss
• risk of hair loss

Complications after Gastric Bypass:

– wound infection, abdominal wall hematoma
– lower limb deep vein thrombosis and pulmonary embolism
– respiratory problems, heart attack
– leak in the surgical connections with the intestines ( 1 – 2 % of cases, may need additional operation)
– bleeding around the surgical connections with the intestines (2 – 5 % of cases, may need endoscopy)
– internal hernia (up to 9 %, occure months after the operation, need surgcal correction)
– anastomotic stricture (late complication, needs endoscopic dilatation)
– dumping syndrome (rapid passage of carbohydrates – sensation of abnormal heart beating, cold sweating, anxiety)
– deficiency of vitamins and minerals

There may be other risks, depending upon your specific medical condition. The risk of complications is lower at centers that perform more than 100 weight loss surgeries per year. And, when performed by a highly experienced surgeon, deaths in the month following gastric bypass surgery are rare: about 0.2% to 0.5%.