Gastric bypass surgery is performed to allow food to bypass part of the stomach, and thereby cause harm. This greatly reduces the size of the stomach, and changes in the body’s physiological response to food intake.
Obesity is associated with development of severe co-morbidities, such as hypertension and diabetes, with complications and their own mortality. Bypass surgery has been shown to reduce the incidence of complications, and reduce related deaths.
Who is eligible?
Selection of patients for bypass surgery should ideally be done by a panel of doctors, including a specialist bariatric (weight loss) surgeon and nutritionist special.
This is a great abdominal surgery with many potential complications, and because it is only for patients who meet strict criteria:
A body mass index (BMI) of 40kg / mТВ or more,
Patients should be well informed and motivated,
Those with an acceptable risk for surgery,
Those who have failed to lose weight through non-surgical methods,
Adults with a BMI> 35kg / mТВ plus serious co-morbidities such as diabetes, sleep apnea, severe joint pain, or obesity-related cardiomyopathy may also be considered.
Patients not suitable for surgery are those with:
Untreated depression or psychosis,
Current drug or alcohol abuse,
Heart disease by non-acceptable risk of anesthesia,
Serious blood clotting disorder,
Inability to meet the nutritional needs of post-surgical life, or
Those that are not age appropriate: surgery is controversial under 18 or over 65.
How is this done?
There are several methods, all of which performed under general anesthesia. Surgery can be performed in a conventional manner, or with laparascope, depending on the skill of the surgeon.
The most frequent – and most successful – method called gastric bypass with proximal Roux-en-Y anastomosis.
The first phase of the operation was to reduce eaten by almost 90 percent, leaving a small pouch, or a mini-stomach to receive food ingested.
The second step involves rearranging the left-upper abdomen, and make the connection between the stomach and small intestine (Y-star) is still possible to mix the food with secretions and hormones are usually produced by the gut during digestion.
Any abdominal surgery has complications, but the risk is greatly increased in obese patients. In addition, there is a complication unique to this method.
Possible complications for abdominal surgery in general:
Infection – incision, or internal surfaces and organs. Obesity can increase the rate of infection, but enough peri-operative use of cephazolin reduced significantly.
Nosebleed – obese people more at risk, because the extra tissue that needs to be incised.
Hernia stars, internal or external.
Due to internal hernia or adhesion of intestinal obstruction.
Pulmonary embolus – risk is increased in obese patients undergoing abdominal surgery.
Specific complications are:
Leaks – many sites reconnect the stomach and intestines,
Depreciation (narrowing) of the openings in the intestine,
Dumping – food through the small intestine too quickly as a normal outlet valve bypassed stomach. Symptoms disposal:
Nausea and vomiting,
Gallstones – usually with rapid weight loss.
Because of small residual stomach vomiting. This may lead to
Lack of nutrition – protein, vitamin and mineral deficiencies general (re – organize anatomic cause weight loss usually leads to malabsorption).
Abdominal distention lips. It is rare, but can be fatal if not diagnosed and treated promptly.
Most patients will be discharged within a few days, after they had to move pain-free, and eat liquid or pureed food without vomiting. Patients should be taught a new way of eating (such as limiting the amount in about one cup per meal), and how to avoid malnutrition. Motivation and constant follow-up care is needed to avoid problems.
Substantial weight reduction in nearly all patients, with an average loss of around 4.5kg months, stabilized after 24 months. Many will require cosmetic surgery to remove excess skin folds.
With the huge increase in obesity-related conditions such as diabetes and hypertension, and a significant improvement in quality of life.