Gastric bypass

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