What is Gastric Bypass Surgery?
Gastric Bypass is the weight loss procedure with the longest track record used in the treatment of obesity around the world. Gastric Bypass surgery is a combined restrictive/metabolic surgical procedure. It is restrictive in the sense that it ‘restricts’ how much food the stomach can hold and is ‘metabolic’ in that it influences gut hormones, blood sugar regulation, and metabolism. This combination surgery has one of the highest success rates for amount of weight lost, making it a popular weight loss surgery option, especially for people with very high BMI’s (typically BMI >50) or diabetes.
The two most common types of Gastric Bypass surgery are the Roux-en-Y, and the Single Anastomosis (Omega-loop) gastric bypass. Other types of bypass include the SADI and duodenal switch procedures. Dr Taylor is experienced in performing all types of gastric bypass surgery, and all are done laparoscopically (keyhole surgery), using 4-5 small incisions. Dr Taylor will help you decide which option is best for you, but generally the Omega-loop gastric bypass is preferred for most patients as it has fewer side effects, unless you have severe gastro-oesophageal reflux disease (such as high grade oesophagitis or Barretts).
In the two most common types of Gastric Bypass surgery, the surgeon creates a small stomach pouch by dividing the stomach into two using surgical staplers along the upper part of the stomach. A new opening from this pouch is then created, and joined to the small intestine using sutures to allow food to exit the pouch (this is called an anastomosis).
This arrangement prevents food entering the larger part of the stomach, and the first 1-2 metres of the small intestine (the duodenum and part of the jejunum). This achieves significant calorie restriction as well as some metabolic effects, including very beneficial alterations to gut hormones, as well as making the composition of gut bacteria healthier (the gut microbiota). However, it may also lead to a reduction in the absorption of certain micronutrients and vitamins, therefore ongoing supplementation and monitoring are important. The Gastric Bypass is highly effective at treating diabetes, which will improve in most cases, and may be put into complete remission, at least for a few years, in many patients. It also has the best long term weight loss results.
Advantages of Gastric Bypass Surgery include:
- The most amount of weight loss of the main procedures - most patients lose 60-80% of their excess weight, even if they are carrying a large amount of extra weight to start with (high starting BMI)
- Excellent long term weight control - multiple studies show continued weight control at several years and beyond
- Improved health problems associated with severe obesity, especially type-2 diabetes
- Improved mobility and quality of life
Am I eligible?
To be considered for the Gastric Bypass you will need to have a Body Mass Index (BMI) of at least 40, or a BMI of at least 35 if major health conditions are already present (the same as for the Sleeve Gastrectomy). CHECK YOUR BMI
Health conditions may include heart disease, high blood pressure, Type 2 diabetes, proven sleep apnoea, severe osteoarthritis, slipped discs in the back, high cholesterol readings, and polycystic ovarian syndrome.
Talk to your doctor to find out more about your eligibility for a Gastric Bypass.
What are the risks of Gastric Bypass?
As with any surgery there are potential risks involved. Whilst most patients do not have complications after Gastric Bypass surgery, complications can occur, and occasionally be quite serious. Recovery and outcome may depend on the patient’s existing health status. Specific complications for Gastric Bypass surgery include:
- DVT (blood clot in the deep leg veins) and or PE (clot in the lungs)
- Leakage of digestive contents from staple lines or anastomoses which can lead to serious infection
- Stricture (narrowing) of the opening between the stomach and small intestine
- Bowel twisting or obstruction caused by either kinking at the intestinal joins or internal hernias
- Dumping Syndrome: Vomiting, abdominal pain, and diarrhoea caused by stomach contents moving too rapidly through the small intestine
- Reduced absorption of key vitamins, minerals or protein leading to the risk of deficiencies if adequate supplements are not taken
- Stomal ulcers (ulcers forming on the anastomosis)