Gastric bypass can be done in two ways. With open surgery, your surgeon will make a large surgical cut (incision) to open up your belly. Your surgeon will do the bypass by directly handling your stomach, small intestine, and other organs.

Another way to do this surgery is to use a tiny camera, called a laparoscope, which is placed in your belly. This is called laparoscopy. In this surgery:

• First, your surgeon will make 4 to 6 small incisions in your belly.
• Then your surgeon will pass the laparoscope through one of these incisions. It will be connected to a video monitor in the operating room. Your surgeon will look at the monitor to see inside your belly.
• Your surgeon will use thin surgical instruments to do your bypass. These instruments will be inserted through the other incisions.
• You will probably stay in the hospital a shorter time and recover more quickly after laparoscopy, compared to open surgery. The biggest benefit of laparoscopic surgery is reduced pain. You will also have smaller scars and a lower risk of developing hernias.

Laparoscopy may not be safe for you if you:

• Have had abdominal surgery in the past. This is because you may have scar tissue from earlier surgery.
• Have severe heart and lung disease
• Weigh more than 350 pounds

There are two basic steps during both kinds of gastric bypass:

• The first step makes your stomach smaller. Your surgeon will use staples to divide your stomach into a small upper section and a larger bottom section. The top section of the stomach (called the pouch) is where the food you eat will go. This pouch is about the size of a walnut. It holds only about 1 ounce of food.
• The second step is the bypass. Your surgeon will connect a part of your small intestine, called the jejunum, to a small hole in your pouch. The jejunum is farther down from where your stomach normally attaches to your small intestine. Food you eat will now travel from the pouch into this new opening into your small intestine. When food travels this way, it bypasses the lower part of your stomach and the first part of your small intestine. Because of this, your body will absorb fewer calories.

This surgery takes about 4 hours.

This surgery may increase your risk for gallstones. Your doctor may recommend having a cholecystectomy (surgery to remove your gallbladder) before your bypass surgery.

Weight loss surgery may be an option if you are very obese and have not been able to lose weight through diet and exercise.

Gastric bypass surgery is not a "quick fix" for obesity. You must be committed to diet and exercise because you need to continue dieting and exercising after the surgery. You may have complications from the surgery if you don’t. One problem some people have is throwing up if they eat more than their new small stomach can hold.

People who have this surgery should be mentally stable, motivated, and not be dependent on alcohol or illegal drugs.

Images

Dumping syndrome

Biliopancreatic diversion (BPD)

Adjustable gastric banding

Biliopancreatic diversion with duodenal switch

Roux-en-Y stomach surgery for weight loss

Vertical banded gastroplasty

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Review Date: 05/17/2010
Reviewed By: Shabir Bhimji MD, PhD, Specializing in Cardiothoracic and Vascular Surgery, Midland , TX Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M., Inc. is accredited by URAC, also known as the American Accreditation HealthCare Commission (www.urac.org)