Clinically obese patient who have made reasonable attempts to control weight through first-line treatments for obesity including low-calorie dietary therapy, physical activity, behavior modification regimen, and medical treatment can consider weight loss surgery as a last resort.
Today, the commonly performed bariatric (weight loss) techniques are the gastric bypass, gastric sleeve surgery, vertical banded gastroplasty (VBG), adjustable silicone gastric banding (ASGB), and biliopancreatic diversion (BPD).
Of these surgical interventions, gastric bypass is considered to be the gold standard for weight loss procedure. It is a restrictive surgery that involves creating a small stomach pouch- about the size of a walnut- from the existing stomach, dividing the small intestine and attaching it to the newly created stomach pouch. Since the majority of the stomach is sealed off, it limits your daily calorie consumption to less than 1,000 and your food intake to about 1 ounce.
Like all other four procedures, gastric bypass procedure may be performed through standard open surgery or laparoscopic technique.
Laparoscopic Procedure Overview
Laparoscopic or minimally invasive gastric bypass surgery involves 4-6 very small incisions in the belly as opposed to one large cut needed in open surgery. Prior to starting the surgery, the patient is given general anesthesia. Once the patient is asleep, carbon dioxide gas is introduced into the abdomen to inflate the stomach cavity so that the surgeon can work effectively in increased space and clearly see the internal organs. A laparoscope (a tiny camera) is then inserted into the abdomen through a trocar (a narrow hollow tube). Other long narrow surgical instruments are inserted through the remaining small incisions. The surgeon and the team can view images of the whole procedure on a video screen.
Who is an Ideal Candidate for This Surgery?
Someone between the ages of 18 and 50, or under 18 but approximately 75 pounds overweight and have a major obesity-related health problem like diabetes or heart disease is an ideal candidate for laparoscopic gastric bypass surgery. Someone with a BMI greater than 40 without any other complications can also undergo this type of surgery.
Who is Not?
People over 60 years of age, those who smoke or use nicotine in any form and those who have already undergone a surgical procedure for weight loss are not an ideal candidate for this weight loss surgery.
Advantages of Laparoscopic Approach
Today, most bariatric surgeons around the world only use the laparoscopic approach for gastric bypass because of the many advantages. A few little holes instead of a huge gash, shorter hospital stays, quicker recovery with rare or no complications and a reduced risk of getting a hernia or infection are the benefits of this minimally invasive form of surgery. Patients also report less pain and return to their normal activities in 3 – 5 weeks.
After the Surgery
You will be encouraged to sit on the side of the bed and walk a few steps the same day you had the surgery. You may have a catheter (tube) that goes through your nose into your stomach for 1 or 2 days to help fluids drain from your belly. A catheter may be put in your bladder to remove urine. You surgeon may give you special stockings to wear on your legs so that you do not develop blood clots. You will get medicine through shots to prevent blood clots from forming.
Post-surgery Diet Plan
You will be asked to consume high protein food supplements for the first 2 weeks following the surgery. After that, you can have liquids, and then pure or soft foods like mashed potatoes, sweet potatoes, yogurt, and soft cheese for a week. Once your stomach starts digesting well, you can take moderate amounts of soft food. Gradually, you will feel strong enough to resume routine activities like walking, shopping, going to work and driving.