Gastric bypass
An Introduction To Gastric Bypass Surgery
WHAT IS GASTRIC BYPASS SURGERY?
The most commonly performed gastric bypass surgery is the Roux-en-Y gastric bypass. This involves permanently dividing the stomach to create a small stomach pouch of 20-30cc which is the size of an egg. The rest of the stomach and the duodenum are bypassed. Part of the small intestine that connects to the new stomach pouch is also bypassed and does not take part in any digestive function. As a result the amount of food intake is restricted by the stomach pouch while the bypassed small intestine reduces the amount of calories absorbed from food.
Following Roux-en-Y gastric bypass procedure the weight loss is rapid in the first 12months and patients can lose up to 75% of their excess weight. However, this is only a guide and the actual mount of weight loss varies from person to person. Increasingly around the world, Roux-en-Y gastric bypass is being performed as a form of metabolic surgery to help resolve or improve the damaging effects of metabolic diseases such as type2 diabetes, high cholesterol, high blood pressure and obstructive sleep apnoea.
This procedure is considered complex and should only be undertaken by an experienced Upper Gastro-intestinal Surgeon, with specialist Bariatric surgery skills.
WHO WILL BENEFIT FROM GASTRIC BYPASS SURGERY?
You may be a good candidate for Gastric Bypass Surgery as a weight loss surgery option. This will be discussed with you at length at your initial consultation with Mr Agwunobi.
Because of the permanent and life changing nature of this surgery, patients must meet a strict selection criteria before they can be considered for this procedure, which is as follows:
- Patients must have a significant history and long-term experience of diet failures
- Patients must demonstrate a genuine desire to overcome their obesity problems
- Patients must make a full commitment to finally getting their weight under control and for the significant diet related changes that will be necessary following surgery
- Patients must become well educated about their condition and fully understand both the benefits and the risks of the weight loss surgery they are considering
- Patients must have a Body Mass Index (BMI) of 35 to 39 with other obesity related health problems
- Or, patients must have a Body Mass Index (BMI) of 40 or above
HOW IS A GASTRIC BYPASS PROCEDURE CARRIED OUT?
The ultimate aim when performing Bypass Surgery is to skillfully fashion a new stomach pouch to become around the size of an egg. This new reduced sized pouch will only be able to contain around 20 - 30cc's of fluid or food at any one time, so it is drastically reduced in size and capacity. The rest of the stomach and upper small intestine are bypassed.
Part of the small intestine that connects to the new stomach pouch is also bypassed thus acting only as a conduit for the ingested food. These two procedures performed in combination with each other restrict both the capacity of the stomach to take on large quantities of food or fluid and also reduce the potential high calorie value of any ingested food.
This procedure can be carried out using minimally invasive approach (through keyhole surgery) or with an open surgical technique (a standard external large incision). Minimally invasive surgery techniques or laparoscopic techniques are becoming increasingly popular with specialist obesity surgeons, as they typically allow a speedier and less painful recovery and potentially pose less risk of wound infection and incisional hernia, among others, to the patient. Mr Agwunobi regularly performs Roux-En-Y gastric bypass using the minimally invasive surgery techniques (laparoscopy) and this usually involves 2-3 nights stay in hospital all being well. When performed by the open technique as may happen very occasionally, the hospital stay is between 5 and 7 nights. Both techniques of surgery are carried out under a general anaesthetic (you will be asleep throughout the procedure).
WHAT IS THE RECOVERY LIKE?
Once a patient is fully recovered from the effects of anaesthetic they are normally encouraged to be as mobile as possible as soon after surgery as possible to avoid complications such as Deep Vein Thrombosis (blood clots in the legs) from developing. Patients will be on fluids and liquid diet only throughout their hospital recovery and their abdomen may feel bruised and uncomfortable, although any discomfort will be controlled with pain killing medication as well as possible.
Patients who recover well are normally discharged home 2 days after surgery if the procedure is performed using the laparoscopic approach or after 5-7 days if an open procedure was performed.
Following discharge, patients are strongly advised to stay gently mobile at home.
Patients will be advised to take a specific amount of recovery time away from work, dependent on the type of work they do, but it is usual to take around two weeks off and to refrain from any strenuous exercise for at least 8 weeks following surgery.
Patients are discharged with strict meal planning advice from our specialist dieticians, but in the first weeks after surgery the majority of patients will be unable to tolerate anything other than a liquid diet. Gradually a patient's ability to tolerate most types of food will improve, although the volume of food they are able to consume in one intake will be substantially and permanently reduced. Patients will be well supported throughout their recovery by our specialist dietician, who will advise and guide patients through the changes to their diet that will be necessary through the rest of their life.
ARE THERE ANY RISKS ASSOCIATED WITH GASTRIC BYPASS SURGERY?
All surgery involves an element of risk from developing complications. Potential risks of gastric bypass procedure will all be discussed openly at consultation with Mr Agwunobi, as well as his scrupulous efforts to manage and minimise these risks to their lowest possible potential.
Smoking will adversely affect wound healing and smokers are strongly advised to stop smoking prior to surgery to avoid potential risks associated with smoking particularly breathing problems. Where effects of smoking are likely to adversely affect the outcome of the surgery in an individual person, he/she may be precluded from having this type of surgery as a result.
Although Gastric Bypass Surgery is regularly performed without any complications, all surgery, no matter how expertly or carefully it is performed, carries risks and the importance of a full evaluation and consultation with Mr Agwunobi to discuss your understanding and expectations in relation to these risks cannot be over emphasised.
Cutting your calorie intake with the help of Gastric Bypass Surgery has more advantages than just guaranteed weight loss. Here are the top 9 benefits of Weight Loss Surgery:
1. Effective And Maintainable Weight Loss
If you have spent years failing to lose weight or become disheartened after piling on the weight you have just struggled to lose then bariatric surgery will ensure that the weight loss you achieve is more easily attained and maintained. Weight loss surgery will stop the 'yo yo' effect so commonly experienced with normal diet regimes. Studies have shown that the majority of weight lost over 5 years with normal diet and exercise regimes is regained over the proceeding five years - if this sounds familiar to you? then obesity surgery could be the most ideal solution to this problem for you!
2. Improved Quality And Quantity Of Life
Nearly all weight loss surgery patients report to having developed a newfound sense of well being after successful surgery. Common feedback suggests that being able to at last focus on other activities other than just focusing on where the next meal will come from brings a tremendous sense of freedom and improved quality of life. In addition, energy levels improve tremendously as weight loss occurs and increases, giving a new opportunity to take on new hobbies and activities that throughout obesity were difficult or even impossible.
3. Improved Appetite Control
Following successful weight loss surgery patients typically report that they are relieved to find that their eternal feelings of hunger and continual pre-occupation with food decreases and diminishes dramatically allowing a new focus on getting into shape and leading a healthier and more fulfilling life style.
4. Improved Health
Obesity related health issues are serious issues and will eventually lead to significant health deterioration and an early death. After successful weight loss surgery you can expect to experience a dramatic improvement or cure in the following conditions:
- Type 2 Diabetes
- High Blood Pressure
- Obstructive Sleep Apnoea
- High Cholesterol
- Heart Disease
- Gastro-Oesophageal Reflux Disease
- Respiratory problems
- Joint And Back Pain
- Osteoarthritis
- Cardiovascular Function
- Infertility
5. Improved Self -Esteem
If you have struggled with your weight for years the long-term sense of guilt, embarrassment, shame and lack of self-esteem can take its toll. Following successful weight loss surgery the vast majority of patients report that they begin to feel proud and less self conscious and embarrassed as their weight loss progressively increases. The positive feelings of gaining confidence and control over a life that has been blighted by long-term obesity related issues are profound.
6. Looking Good
A slimmer healthier body is a pleasure to dress and look after and as patients start to loose their pounds and look better, they also tend to take greater pride in their outward appearance and begin to pay more careful attention to their wardrobe, hair or make-up. Successful weight loss candidates report that shopping for regular sized clothes becomes a pleasure rather than a chore.
7. Relations and opportunities
It's sad but true that your size and outward appearance can prejudice and influence the perception and attraction of others at work, at home and within relationships. Most successful weight loss surgery candidates experience a most positive and supportive reaction from those around them to their weight loss efforts and in turn report that favourable opportunities in relations, lifestyle and at work seem to increase as their weight decreases.
8. Mobility And Comfort
Most patients who have endured long-term obesity suffer with physical pain and discomfort of some sort or another as their weight escalates. Following weight loss surgery what may have been an overwhelming challenge pre-operatively becomes increasingly achievable, manageable and comfortable.
9. Economic Benefits
Living in a thin persons body rather than an obese persons body can have a significant and positive impact on your grocery bills - the economic benefits of not having to eternally search and shell out for the next large meal and have a continually packed fridge and freezer is a significant financial benefit to all successful weight loss surgery candidates.
Are You Ready For the Next Step?
HOW DO I FIND OUT IF I AM A SUITABLE CANDIDATE FOR GASTRIC BYPASS SURGERY?
If you wish to find out if you are a suitable candidate for Gastric Bypass surgery, Mr Agwunobi will carry out a full evaluation of your individual needs and circumstances and provide you with a comprehensive verbal and written explanation of any recommended treatment or surgery.
Mr Agwunobi understands the importance of the weight loss surgery you are contemplating and throughout your consultation you will be encouraged to ask as many questions as you wish and to take your time in making a decision to proceed with any treatment or not.
Find out more
If you would like to find out more about gastric banding and discover if you are a suitable candidate for this procedure, please telephone 0161 432 2061, email or use the Contact form to organise a consultation appointment.