Gastric Bypass Surgery via the Roux-en-Y procedure is generally considered to be the best surgical procedure for the treatment of morbid obesity. Weight loss is achieved by reducing the functional portion of the stomach to a pouch one ounce or less in size, and by creating a stoma, a small opening between the stomach and the intestine.
After the gastric bypass procedure, a small size of the stomach pouch causes the patient to have a sensation of fullness after eating only a small portion of food. The small stoma delays stomach emptying, making the sensation of fullness last longer. These are called the Restrictive components of the procedure.
The limb of intestine coming down from the small pouch is called the Roux limb. The limb of intestine coming down from the bypassed portion of the stomach can be called the Biliary or Bypassed limb. The remaining portion of the intestine is called the Common Channel.
Food does not pass down the Bypassed limb, only the Roux limb and the Common Channel. The longer the Bypassed limb, the less the length of intestine actively working to absorb nutrients from the food that is eaten. Digestive juices that normally help absorb nutrients from the food enter the Bypassed limb from the larger portion of the stomach, the liver, and the pancreas, and pass down the Bypassed limb to the Common Channel. These juices do not mix with the food while it is passing down the Roux limb. The longer the Roux limb, the longer the portion of intestine trying to absorb nutrients without the benefit of these digestive juices. Both of these changes result in less absorption of nutrients and contribute to weight loss, and are called the Malabsorptive components of the procedure.
Exactly how the operation is done for an individual patient depends on their individual anatomy, their general health status, whatever changes they may have from prior surgeries, and what they hope to be achieve from the operation. The stomach compartments can be completely divided from each other or simply partitioned, the small stomach pouch and the intestinal limbs may be connected to each other with either staples or sutures, a small band may be placed around the stomach pouch, and the two intestinal limbs may be made longer or shorter.
What are the pros and cons of gastric bypass surgery?
As with any major life changing surgery there are many pros and cons and all should be thoroughly explored and discussed with your doctor and family before undergoing the procedure. None of these are an absolute. They may or may not happen -- both pro and con. Be prepared for these possibilities.
Cons:
Urinary Tract Infection
Bowel Obstruction
Obstruction of the stomach outlet: the outlet post surgery is about the size of the tip of your pinky finger. You have to learn to chew everything you swallow to be less than that! You will not have stomach acid in the pouch; consequently, if you swallow anything bigger it’s stuck.
Chronic nutritional problems
Protein deficiency
Vitamin deficiency
Mineral deficiency
Nausea
Food Intolerances such as: Sugar, Milk and Milk Sugar, and Red Meats.
Changed Bowel Habits
Transient Hair Loss: During the rapid weight loss following the surgery you will probably lose much of your hair. It will grow back. My doctor told me to invest in some nice hats for the duration.
Loss of muscle mass
Pros:
Loss of high blood pressure: 70% of patients are able to go off all blood pressure medications post-op.
Loss of high blood cholesterol: 80% of patients develop normal cholesterol levels within 2-3 months after surgery.
Reduced risk of heart disease
Increased probability of reducing all need for medication in a diagnosed Type II Diabetes patient.
Reversal of borderline diabetes
Reduced asthma attacks, and in some cases a total discontinuation.
Reduced Respiratory Insufficiency: Many patients find that within just months of the surgery they have almost no respiratory problems at all and can participate in normal activities they have missed out on for years.
Relief of Sleep Apnea Syndrome
Relief from Acid Reflux Disease
