Gastric Bypass
Definition:
- Gastric bypass is the surgical procedure for obesity treatment. This involves in creating a stomach pouch which restricts food intake. Small intestine is attached directly to new stomach pouch, bypassing lower stomach and duodenum. The patient eats less after surgery as he/she feels full sooner, leading to loss of weight.
- Surgery is possible via
- Laparoscope
- Open Incision
Why it is needed:
- This surgery is prescribed when obese patients cannot lose weight by other methods.
- Ideal candidate for surgery:
- BMI -body mass index equal to 40 or more
- Those whose BMI is 35 or more, but suffer from medical conditions such as diabetes, sleep apnoea, osteoarthritis, heart disease and so on, and would benefit from weight loss
- Aged between 18 -55 years and willing to followed prescribed diet (and restrictions)
Facts and Figures:
- Obesity causes premature deaths worldwide. It is ranked second in the cause of preventable deaths in US, where it causes 300,000 deaths every year.
- Linner and Kremen performed the first surgery, which led to the modern method of bariatric surgery
- Advantages and Disadvantages:
- Advantages:
- Marked weight reduction after surgery. It makes life comfortable as patients as it eases daily activities and movement.
- Definite improvement is observed in medical conditions such as asthma, hypertension, diabetes, sleep apnoea etc.
- Disadvantages:
- Surgery may increase chance of developing gall bladder stones.
- Chance for developing Hernia.
- Malnutrition may occur leading to Osteoporosis, Anemia and/ or Depression.
- Leaking via the staples in stomach post surgery may need emergency surgery
Risks and Complications:
- Reaction to medication or anaesthesia
- Pulmonary embolism
- Blood clots
- Pneumonia
- Bleeding
- Injuries to intestine, stomach, or adjacent organ/s
- Dumping syndrome
Pre-operative and Post-operative Care:
- Pre-operative preparation:
- Full body physical examination
- Blood plus urinalysis
- Ultrasound - abdomen
- Visiting surgeon to have list of medicines for pre and post surgery
- Inform surgeon about alcohol or smoking habits
- Nutritional counselling
- Receiving counselling for mental health, to cope with emotional and physical changes post surgery
- Arrange work leave, help at home and driving, and post operative care
- Fasting after midnight before surgery
- Medical tourist should select handicapped accessible hotel near hospital post surgery recuperation
Post-operative care:
- Patients have stay for 3-5 days in hospital post surgery. Catheter is used to drain body fluids, which is removed within 1-3 days post surgery
- Pain medication is given
- Patients have to ingest liquids for 1-3 days, then soft food is allowed
Do’s, Don’ts and Precautions:
- Do eat small amounts at one go
- Avoid foods having simple sugars like juice, candy, juice, beverages, condiments, soft drinks to avoid ‘Dumping syndrome’
- Do follow diet prescribed strictly. Exercise regularly to receive best outcome of surgery
