Gastric bypass is the most commonly performed and most well-investigated bariatric operation. It has been performed with success for more than 20 years. It involves reducing the size of the stomach, bypassing a portion of the small intestine and reconstructing a portion of the intestine to create what is called a "Roux-en-Y" limb.
Under general anesthesia, the surgeon creates a small pouch at the top of the stomach and adds a bypass around a section of the small intestine, which is shaped like a "Y." The pouch is created by stapling the upper portion of the stomach and sealing it off from the rest of the stomach. Complete disconnection of the pouch from the remaining bypassed stomach is important as it can reduce such complications as staple separation.
This pouch is about the size of a walnut and holds one ounce of food. It is connected directly to the bypassed section of the small intestine. By rerouting the path that food follows, many of the calories and nutrients pass through the digestive system without being absorbed. The length of small intestine that is bypassed can vary depending on the surgeon's technique, but can affect the degree of weight loss and weight maintenance. Our bariatric team believes that longer bypasses offer better and safer results. Weight loss is rapid in the first six months following this surgery, peaking at 18 to 24 months following surgery.
Gastric Bypass Procedure
Gastric bypass is now performed laparoscopically (with small keyhole incisions) and is considered the standard of care. Rather than making a single large incision, the surgeon makes five to seven small (¼- to ½-inch) incisions in the abdomen through which instruments, including a lighted viewing scope, are inserted and the operation is performed.
The patient's abdomen is inflated with carbon dioxide to provide "working space" for the surgeon to create the bypass while observing the process through the viewing scope.
Because there is less physical trauma with a laparoscopic procedure, recovery from surgery is much faster than in open surgery. Patients who undergo laparoscopic procedures are hospitalized for one to three days, compared to four to five days for open surgery.
It is our experience that with appropriate expertise and skills almost all patients regardless of previous surgeries, weight or body build can enjoy the benefits of the laparoscopic technique.