Gastric bypass surgery


Definition

Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat.

After the surgery, your stomach will be smaller. You will feel full with less food.

The food you eat will no longer go into some parts of your stomach and small intestine that absorb food. Because of this, your body will not get all of the calories from the food you eat.

Alternative Names

Bariatric surgery - gastric bypass; Roux-en-Y gastric bypass; Gastric bypass - Roux-en-Y; Weight-loss surgery - gastric bypass; Obesity surgery - gastric bypass

Description

You will have general anesthesia before this surgery. You will be asleep and pain-free.

There are 2 steps during gastric bypass surgery:

Gastric bypass can be done in two ways. With open surgery, your surgeon makes a large surgical cut to open your belly. The bypass is done by working on your stomach, small intestine, and other organs.

Another way to do this surgery is to use a tiny camera, called a laparoscope. This camera is placed in your belly. The surgery is called laparoscopy. The scope allows the surgeon to see inside your belly.

In this surgery:

Advantages of laparoscopy over open surgery include:

This surgery takes about 2 to 4 hours.

Why the Procedure Is Performed

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

Doctors often use the body mass index (BMI) and health conditions such as type 2 diabetes and high blood pressure to determine which people are most likely to benefit from weight-loss surgery.

Gastric bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of what you eat, and exercise. If you do not follow these measures, you may have complications from the surgery and poor weight loss.

Be sure to discuss the benefits and risks with your surgeon.

This procedure may be recommended if you have:

Risks

Gastric bypass is major surgery and it has many risks. Some of these risks are very serious. You should discuss these risks with your surgeon.

Risks for anesthesia and surgery in general include:

Risks for gastric bypass include:

Before the Procedure

Your surgeon will ask you to have tests and visits with other health care providers before you have this surgery. Some of these are:

If you smoke, you should stop several weeks before surgery and not start smoking again after surgery. Smoking slows recovery and increases the risks for problems. Tell your doctor or nurse if you need help quitting.

Tell your surgeon or nurse:

During the week before your surgery:

On the day of surgery:

After the Procedure

Most people stay in the hospital for 1 to 4 days after surgery.

In the hospital:

You will be able to go home when:

Be sure to follow instructions for how to care for yourself at home.

Outlook (Prognosis)

Most people lose about 10 to 20 pounds (4.5 to 9 kilograms) a month in the first year after surgery. Weight loss will decrease over time. By sticking to your diet and exercise from the beginning, you lose more weight.

You may lose one half or more of your extra weight in the first 2 years. You will lose weight quickly after surgery if you are still on a liquid or pureed diet.

Losing enough weight after surgery can improve many medical conditions, including:

Weighing less should also make it much easier for you to move around and do your everyday activities.

To lose weight and avoid complications from the procedure, you will need to follow the exercise and eating guidelines that your doctor and dietitian have given you.

References

Buchwald H. Laparoscopic Roux-en-Y gastric bypass. In: Buchwald H, ed. Buchwald's Atlas of Metabolic and Bariatric Surgical Techniques and Procedures. Philadelphia, PA: Elsevier Saunders; 2012:chap 6.

Buchwald H. Open Roux-en-Y gastric bypass. In: Buchwald H, ed. Buchwald's Atlas of Metabolic and Bariatric Surgical Techniques and Procedures. Philadelphia, PA: Elsevier Saunders; 2012:chap 5.

Halperin F, Ding SA, Simonson DC, et al. Roux-en-Y gastric bypass surgery or lifestyle with intensive medical management in patients with type 2 diabetes: feasibility and 1-year results of a randomized clinical trial. JAMA Surg. 2014;149(7):716-726. PMID: 24899464 www.ncbi.nlm.nih.gov/pubmed/24899464.

Mingrone G, Panunzi S, De Gaetano A, et al. Bariatric-metabolic surgery versus conventional medical treatment in obese patients with type 2 diabetes: 5 year follow-up of an open-label, single-centre, randomised controlled trial. Lancet. 2015;386(9997):964-973. PMID: 26369473.\ www.ncbi.nlm.nih.gov/pubmed/26369473.

Richards WO. Morbid obesity. In: Townsend CM Jr, Beauchamp RD, Evers BM, Mattox KL, eds. Sabiston Textbook of Surgery. 19th ed. Philadelphia, PA: Elsevier; 2012:chap 15.

Thompson CC, Morton JM. Surgical and endoscopic treatment of obesity. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger and Fordtran's Gastrointestinal and Liver Disease. 10th ed. Philadelphia, PA: Elsevier Saunders; 2016:chap 8.

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