Medical research documents the many diseases that develop more frequently in obese individuals. A recent study revealed the direct correlation between obesity and a shortened lifespan. ... Weight loss is actually a common prescription for disorders like high blood pressure, high cholesterol, heart disease, diabetes, sleep apnea, infertility, heartburn, and in preparation for hernia repair and joint replacement.
A BMI of 25 or more is considered overweight; 30 or more, obese; and 40 or more, morbidly obese. Bariatric surgery may be offered to patients with severe obesity when medical treatments, including lifestyle changes of healthful eating and regular exercise, have not been effective.
The gastric bypass operation was described by Mason in 1969 and has evolved, with many variations, since the original loop technique. Many investigators, including Dr. Henry Buchward, abandoned the loop technique because of many complications, such as alkaline gastritis and esophagitis, and the Roux-en-Y technique was brought forward and refined.
The standard gastric bypass performed today is an isolated Roux-en-Y gastric bypass (RYGB), meaning that the stomach is completely divided. A small gastric pouch approximamtely 15 to 30 cc in size is constructed and connected to a Roux limb. The Roux limb is made typically 75 to 150 cm in length and is in turn connected to the biliopancreatic limb. ... The procedure can be performed through a midline incision but the majority of procedures performed today use the laparoscopic approach.
Another type of gastric bypass is the laparoscopic mini-gastric bypass (LMGBP), first reported by Rutledge. In this procedure a gastric pouch is created and a point selected on the small bowel about 200 cm distal to the ligament of Treitz. The jejunal loop is brought up antecolic, and a stapler is used to anastomose the stomach and the small bowel at this point.
After Roux-en-Y gastric bypass, patients feel early satiety and report enjoying healthy food options. These behavioral changes are mainly due to alterations in hormones such as ghrelin, gastric inhibitory poly-peptide, glucagon-like peptide, and peptide YY that produce neural signals between the gastrointestinal tract and the hunger centers in the brain.
Typically, the amount of small bowel bypassed is not enough to create micronutrient or protein malnourishment. Anemia and osteoporosis are common long-term deficiencies that may develop as calcium and iron are absorbed by the bypassed segment of intestine.
Weight loss after gastric bypass surgery is often dramatic. On average, patients lose 60% of their extra weight. For example, a 350-pound person who is 200 pounds overweight would lose about 120 pounds.
Weight regain was observed withing 24 months after surgery in approximately 50% of patients. Both weight regain and surgical failure were higher in the superobese group.
Risks common to all surgeries for weight loss include an infection in the incision, a leak from the stomach into the abdominal cavity or where the intestine is connected (resulting in an infection called peritonitis), and a blood clot in the legs (deep vein thrombosis, or DVT) or lung (pulmonary embolism). Some people develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis.
Many patients who undergo LRYGB experience a phenomenon known as "dumping syndrome", which...results in unpleasant flushing, cardiac palpitations and nausea when the patient eats foods rich in carbohydrates (such as desserts). While these side effects are unpleasant and can continue to be present as late as 10 years after the operation, they also work as negative reinforcement...
Gastric bypass is one of the most common types of bariatric surgery in the United States. Many surgeons prefer gastric bypass surgery because it generally has fewer complications than do other weight-loss surgeries.