Lap Gastric Bypass Surgery

Also known as Bypass, Roux-en Y Gastric Bypass and Gastric Weight Loss Surgery

In summary, one loses weight by eating less and absorbing less.

You want to eat less to lose weight. With a gastric bypass, your stomach will hold less food. You’ll therefore eat less and your body cannot absorb ALL of the calories that you consume. This results in weight loss but ask Dr Dhir and the team at Melbourne Gastro Surgery about what the best weight loss surgery options are for you.

These operations include Roux-en-Y Gastric Bypass (RYGBP) and Mini Gastric Bypass (MGP) among others.

Introduction

This page refers to Roux-en-Y Gastric Bypass Surgery (RYGBP) as a Weight Loss Surgery option for selected patients. Gastric Bypass surgery for weight loss involves a number of irreversible operative features. The gastric bypass surgery helps patients to achieve weight loss by (a) decreasing the VOLUME that the stomach can hold, while leaving the ‘extra’ stomach in place and (b) diverting food away from the part of the bowel that absorbs fat and sugar as well as important other nutrients.

How does the gastric bypass procedure work to help you lose weight?

By decreasing food intake (volume) and reducing the ability of the body to absorb calories, a gastric bypass procedure will help patients achieve significant weight loss. It can usually help conscientious patients suffering severe obesity to attain a decrease of up to 85% of their excess weight.

However, gastric bypass surgery does includes some aspects that may be considered complications. Problems with gastric bypass surgery include syndromes such as “dumping,” malabsorption of nutrients and sometimes an excessive amount of weight loss.

Also, gastric bypass surgery appears to have a relatively high complication rate of approximately 5%.

Weight Loss Surgery Options other than Gastric Bypass, Gastric Sleeve or Gastric Lap Band (Gastric Band) surgery

Although there are operations that can achieve even greater weight loss, these other operations are seldom performed in Australia for a number of reasons. A key reason is that some procedures have been linked with excessive weight loss or malnutrition for some patients. For select patients, the gastric bypass procedure is considered the operation for the largest amount of weight loss.

Gastric Bypass Surgery: Number of Procedures that may be Required

Sometimes a gastric bypass is performed as a 2 stage operation but this depends on numerous factors. If necessary for the patient, the second stage of gastric bypass surgery would be performed AFTER a significant amount of weight loss has occurred.

Revisional Weight Loss Surgery or the Gastric Bypass Surgery for Obesity

When previous weight loss surgery, such as a gastric band or gastric sleeve, fails to achieve adequate weight loss – or when complications occur after prior weight loss surgery – a gastric bypass surgery may be the preferred operation. Ask our leading Gastro-Intestinal Surgery Team & Weight Loss Surgeons what your options are by phoning us today on (03) 9466 7799. We look forward to assisting you with finding a solution to your weight management concerns and other digestive, gastro-intestinal or oesophegeal health problems.

The Gastric Bypass Surgery – Operation Overview

Five small (5 to 15mm) incisions are made in the wall of the abdomen and long thin instruments introduced through them including a camera.

The inside of the abdomen can then be visualised and manipulated. A small amount of the stomach is separated off using a surgical stapler, creating a short, pocket shaped, pouch like stomach. The remaining stomach is left in place. The bowel is then divided and rejoined in such a way so as to divert food from the stomach to a part of the bowel that is further along the digestive tract; it’s an area of the bowel that is not efficient at absorbing fat and sugars.

There are numerous surgical joins required during Gastric Bypass surgery.

This operation should be considered irreversible.

Gastric Bypass Revision Surgery

When being performed for revision purposes, there is often scar tissue from the previous operation. This makes the revision operation more difficult than the primary, original gastric bypass procedure. Therefore there are higher risks involved with this procedure; potentially the operation may need to be slightly modified by the Bariatric Weight Loss Surgery Specialist to maximise patient safety.

Sometimes this results in the operation needing to be performed over 2 distinct stages. For example, Stage 1 might be the removal of the gastric band, and Stage 2 (months later) might be the Gastric Bypass Surgery.

Quite often there is a slight distortion of the stomach (Hiatus Hernia) near where the stomach bypass is to be made. The hiatus hernia may be repaired, when present.

How long does a Gastric Bypass Surgery take?

The operation typically takes from 90 to 120 minutes, depending on the patient and other factors. It usually requires four (4) nights stay in hospital after surgery and two weeks of convalescence (initial healing and recovery).

The incisions allow the insertion of a camera, a liver retractor and instruments to grasp structures, cut and staple. Sometimes surgical incision lines become infected in some patients. The incision area most likely to become infected is the left lower incision. Always follow your post-surgery instructions carefully and contact your Weight Loss Surgery specialist immediately with any post-surgery concerns.

Dumping And Malabsorption

These are unpleasant experiences caused by food leaving the stomach being diverted to a new part of the bowel. After gastric bypass weight loss surgery, if you eat large amounts of sugar or fat, you can end up with sweatiness, faintness, bloating and diarrhoea. To avoid these uncomfortable scenarios, you’ll need to eat smaller meals with a variety of foods. Ask us about our e-book about nutrition and the best diet plans after weight loss surgery.

Excessive weight loss and malnutrition after Gastric Sleeve Surgery

These can sometimes occur, especially if patients are not suitably monitored. Regular review by your Specialist Bariatric Surgeon and Weight Loss Surgery team and blood tests are required. The most common nutritional problems relate to Vitamins and Iron uptake, but there are also others we will want to monitor for you after weight loss surgery.

Only very rarely is modification surgery required to prevent further weight loss.

Does GASTRIC BYPASS SURGERY really work FOR WEIGHT LOSS?

Between 200 and 300 gastric bypass procedures are performed per year around Australia.

The majority of gastric surgery patients are able to achieve around an 85% loss of their excess body weight.

The Gastric Bypass procedure is also typically a preferred treatment option, when Revision Weight Loss Surgery is required, e.g. when the Gastric Band or Gastric Sleeve operation failed to result in adequate weight loss for the patient.

Operative Risks OF GASTRIC BYPASS SURGERY

For any weight loss operation there are risks.

These will be discussed with you in detail during a consultation or before consenting to surgery.

In particular, with weight loss surgery, there are risks of infection, bleeding and injury.

The overall risk of major complications for Gastric Bypass Surgery or other weight loss operations tends to be 5% higher during Revision Surgery.

The most common major surgical complication is a staple line leak. This occurs in 2% to 5 % of gastric bypass surgery cases.

The outcomes for gastric bypass surgery typically include few, if any, complications for many patients – and for those that have complications, they are primarily of a minor problem that will pass, such as treatable infection around an incision line (~5%). However, you will need to assure that you read and fully understand all potential complications from this surgery. Ask our Specialists in Weight Loss Surgery  & Gastro-Intestinal Health for details.

More Information

Gastric Bypass surgery is very effective. However it is important to consider the other options, namely Gastric Band and Lap Sleeve Gastrectomy. Information on each of these can be found on our Weight Loss Surgery Website or ask us for an information sheet, including A Guide to Weight Loss Surgery.

This brief information is NOT intended as medical advice and is best considered as a reference or starting point only for discussions about surgery, risks, and other weight loss options.  It is to be used only in conjunction with discussions with your Surgeon and it does not constitute a medical-patient relationship.

To discuss weight loss surgery including Roux-en-Y Gastric Bypass surgery with Mr. Arun Dhir, please ask your GP for a referral to Dr Arun Dhir at Melbourne Gastro Surgery for a consultation about your suitability for these types of Bariatric operations.