About Gastric Bypass Surgery
A gastric bypass operation involves creating a small stomach pouch and bypassing part of your small intestine to make your digestive system shorter, although nothing is actually removed. This means that you can only eat small meals and your body absorbs less food.
Surgery is usually recommended only if non-surgical treatments, such as diet, exercise and medicines haven't worked.
Bilio Pancreatic Diversion Bypass
The biliopancreatic diversion bypass is performed through open surgery with one long incision, leaving a permanent scar. It is less common and more complicated than the Roux-en-Y-gastric bypass.
In the biliopancreatic diversion, portions of the stomach are removed and the bypass is attached to the distal illium. This procedure is not widely used, because there is more risk of nutritional deficiencies.
What Are The Alternatives ?
An alternative surgical option is to have gastric band surgery. Your surgeon will explain your options to you.
Preparing For Your Gastric Bypass Operation
Your surgeon will explain how to prepare for your operation. For example if you smoke you will be asked to stop, as smoking increases your risk of getting a wound infection and slows your recovery.
The operation usually requires a two to four day stay in hospital and is done under general anaesthesia. This means you will be asleep during the operation.
You will be asked to follow fasting instructions. Typically you must not eat or drink for about six hours before a general anaesthetic. However, some anaesthetists allow occasional sips of water until two hours beforehand.
At the hospital your nurse may check your heart rate and blood pressure, and test your urine.
Your surgeon will usually ask you to sign a consent form. This confirms that you understand the risks, benefits and possible alternatives to the procedure and have given your permission for it to go ahead.
You may be asked to wear compression stockings to help prevent blood clots forming in the veins in your legs. You may need to have an injection of an anti-clotting medicine called heparin as well as, or instead of, stockings.
About The Operation
Your surgeon will use surgical staples to create a pouch from the upper part of your stomach, separating it from the rest. A section of your small intestine is then bypassed and re-connected to the pouch. Food takes a shorter route through your digestive system, and so less food is absorbed by your body. Gastric bypass can be done using keyhole (laparoscopic) or open surgery. The operation takes between one and three hours.
Your surgeon will make four to five small cuts on your upper abdomen. He or she will then use small instruments that are guided by a special telescope with a camera to perform the operation. Afterwards, the skin cuts are closed with several stitches.
A single cut (about 30cm long) is made on your upper abdomen to perform the operation. Afterwards, the skin cut is closed using stitches and staples.
What To Expect Afterwards ?
You will need to rest until the effects of the anaesthetic have passed. You may need pain relief to help with any discomfort as the anaesthetic wears off.
You may have a catheter to drain urine from your bladder into a bag. You may also have fine tubes running out from the wound. These drain fluid into another bag and are usually removed after a day or two.
You may have a tube passing through your nose to your stomach for the first day. This drains air and fluid from your stomach to stop you feeling sick and bloated.
On the first day, you may have to wear special pads, attached to an intermittent compression pump, on your lower legs. The pump inflates the pads and encourages healthy blood flow in your legs and helps to prevent deep vein thrombosis (DVT).
What Are The Risks ?
Gastric bypass surgery is commonly performed and generally safe. However, in order to make an informed decision and give your consent, you need to be aware of the possible side-effects and the risk of complications of this procedure.
These are the unwanted, but mostly temporary effects of a successful treatment, for example feeling sick as a result of the general anaesthetic.
You are likely to have some bruising, pain and swelling of the skin around the healing wounds.
You may feel or be sick after eating, especially if you try to eat too much. If you eat too many sugary foods you can get an unpleasant sensation, called "dumping", which may make you feel sick or faint, or give you diarrhoea. You should drink plenty of fluids until the feelings have passed, and you should also reduce the amount of sugary foods you eat. Your restricted diet may cause some shortage of nutrients so you may need to take multivitamin tablets.
This is when problems occur during or after the operation. Most people are not affected. The possible complications of any operation include an unexpected reaction to the anaesthetic, excessive bleeding or developing a blood clot, usually in a vein in the leg (DVT).
Some of the complications you may get after a gastric bypass operation are listed here
- Infection : - antibiotics are usually given during surgery to prevent infection.
- Damage to other organs in your abdomen : - you may need further surgery to repair any damage.
- Bowel leak : - the point where your intestine is re-joined to your stomach pouch could leak in the first few days and you may need further surgery to repair this.
- Gallstones : - there is a risk you may develop gallstones if you lose weight quickly. These can be painful and you may need surgery to remove them. Your surgeon may advise removing your gallbladder when you have your operation.
- Failure to lose weight : - it's possible you may fail to lose sufficient weight or regain weight after bypass surgery.
There is a chance your surgeon may need to convert your keyhole procedure to open surgery. This means making a bigger cut on your abdomen. This is only done if it's impossible to complete the operation safely using the keyhole technique.
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