Laparoscopic Gastric Bypass Procedure

For people who are morbidly obese (i.e people weighing 100 pounds more than their ideal weight), exercise and diet do not usually help in reducing weight. Morbid obesity leads to many health problems and so, reduction of weight becomes necessary. In such cases, when surgery is the only option left, in order to reduce weight, gastric bypass surgery is suggested. Laparoscopic gastric bypass surgery and open gastric bypass surgery are the two types of gastric bypass surgery. Both these surgeries differ in the procedures followed. Laparoscopic gastric bypass surgery is always preferred to open gastric bypass surgery because of less complications.

Before the Surgery

The procedure followed before a laparoscopic gastric bypass surgery is as follows:

• The surgeon studies the endocrine, cardiovascular and pulmonary system of the patient.
• The surgeon then tries to determine the ability of the patient to accept the changed lifestyle after the surgery.
• The patient is made aware of the procedure followed and the change in diet after the surgery.

Laparoscopic gastric bypass surgery is usually not recommended to people who have,

• Weight above 350 pounds
• Lung and heart problems
• A history of an abdominal surgery

Procedure of Surgery

The procedure aims at making the stomach smaller in size, so that the patient will feel satiated with very less amount of food, and thus, ensure that the body absorbs less amount of calories. Lets us understand how the food consumed, is digested in the gastric system and how the surgery helps to reduce the weight of the patient. When the food enters into the stomach from esophagus, gastric juices secreted by the stomach are mixed with the food. Later the food passes to the small intestine. There are two main sections of small intestine, the duodenum (former part) and the jejunum (later part). Fats are broken down and nutrients are absorbed in the small intestine. Now in laparoscopic gastric bypass surgery, the stomach is made small. The surgery lasts for almost 4 hours. The following steps give a brief idea about the procedure of laparoscopic gastric bypass surgery.

• The patient is given general anesthesia before the surgery begins. 5-6 incisions are made in the belly. The diameter of each incision is not more than one inch.
• A laparoscope (a tube with a camera at its one end), is then inserted through one of the incisions.
• This camera is connected to a video monitor, thus enabling the surgeon to view the internal structure of the stomach.
• Air (carbon dioxide) is filled in the stomach so that the stomach inflates and the surgeon gets a better view of the internal structure.
• Thin surgical instruments are passed through the remaining incisions to do the surgery.
• The upper part of stomach is stapled to form a pouch like structure, the size of a walnut. The remaining portion of the stomach is isolated.
• The pouch is directly connected to the second part of lower intestine, jejunum. Thus, almost 95% of the stomach area is bypassed.

After the Surgery

The bypass of a part of the gastric system, results in less absorption of calories from the food consumed. The procedure followed after surgery is as follows:

• The patient is hospitalized for at least 3 days after the surgery. The patient is not allowed to eat anything during this period, because the stitches made in the stomach need to heal.
• After this, the patient has to follow a specific diet, which starts with liquids, then gradually to regular food.
• When the patient eats food, it will enter the pouch and later, directly enter the second part of small intestine. Thus, the amount of calories that are usually absorbed in the small intestine are reduced to great extent.

The lower part of stomach that is bypassed, continues to secrete the gastric juices that flow from duodenum to jejunum. The pouch being very small in size holds a very less amount of food. Thus in the beginning the patient should eat very less food, else it will lead to problems like vomiting. The diet of the patient is restricted and he/she has to adjust to this new lifestyle.

There are many good and as well as some negative long term effects of laparoscopic gastric bypass surgery. The patient reduces 80% of the extra weight gained earlier. The severity of health problems due to obesity, like diabetes type 2, high blood pressure, arthritis, sleep apnea are reduced after the surgery. However, the patient may suffer from nutritional deficiency due to less absorption in the small intestine. Proper food supplements should be taken to avoid these deficiencies. Regular exercise and diet will help the patient to maintain the reduced weight for a long period of time.