Gastric bypass

The risk of malabsorption is of greater concern in gastric surgeries that skip over a larger portion of the small intestines. These are performed much less commonly than the Roux-en-Y gastric bypass as described.

LAPAROSCOPY

Gastric bypass can be performed using a laparoscope. This less-invasive technique allows the surgeon to make smaller incisions, which lowers the risk of large scars and hernias after the procedure.

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First, small incisions are made in your abdomen. The surgeon passes slender surgical instruments through these narrow openings. The surgeon also passes a camera (laparoscope) through one of these small openings and watches through a lens and video monitor to do the surgery.

TYPES OF WEIGHT LOSS SURGERIES

Weight loss surgery can be divided into three types:

Restrictive procedures reduce the size of your stomach.
Malabsorptive procedures alter the flow from your stomach to your intestine, causing poor absorption of calories, vitamins, and minerals in the intestine.
Combination procedures involve characteristics of both restrictive and malabsorptive procedures.

Gastric bypass surgeries are combination procedures that use both restriction and malabsorption to achieve weight loss.

Because it is a combination approach, it tends to be more successful for weight loss than purely restrictive surgeries. However, your body may not absorb vitamins and minerals properly.

Restrictive-only procedures are not as successful. It is easy to "cheat" and eat too much food, over-stretching the newly created stomach pouch.

Indications:

Gastric bypass surgery may be an option if you are significantly obese and have tried unsuccessfully to lose weight on diet and exercise programs and are unlikely to lose weight successfully with non-surgical methods.

Gastric bypass surgery is not a "quick fix" for obesity. The surgery can take several hours and has risks and possible complications. For example, vomiting following the surgery is not uncommon because of eating more than the new, small stomach can accommodate.

Your commitment to diet and exercise must be very strong because even after the surgery, you must adhere to these lifestyle changes. Otherwise, complications from the surgery are likely to develop.

The procedure may be considered for obese individuals who have:

A Body Mass Index (BMI) of 40 or more. BMI is a calculation based on height and weight that is used to determine whether you are of normal weight or are overweight. Someone with a BMI of 40 or more is at least 100 pounds over their recommended weight. A normal BMI is between 18.5 and 25.
A BMI of 35 or more along with a life-threatening illness that can be made better with weight loss, such as sleep apnea, type 2 diabetes, and heart disease.

LAPAROSCOPY

Not everyone is a candidate for the laparoscopic (minimally invasive) approach. If you weigh more than 350 pounds or if you have had abdominal surgery in the past, you are probably NOT a good candidate for laparoscopy. Your surgeon will determine the best and safest approach for you.