The gastric bypass (also known as the roux-en-y gastric bypass) is a keyhole operation which involves making a small pouch from your stomach. The middle portion of the small bowel is attached to this pouch which results in food bypassing most of the stomach and the upper portion of the small bowel. The gastric bypass causes weight loss by reducing the amount of food you can eat and changes to the body’s hormones.
Common questions about the Gastric Bypass
Q: Is the gastric bypass right for me?
Our weight-loss team will always discuss the options available to you. You may be suitable for gastric bypass surgery if you fulfil the following criteria:
- Your BMI (body mass index) is 35 or more and you have medical problems associated with your weight such as type 2 diabetes or high blood pressure.
- Your BMI is 40 or more without any medical problems associated with your weight.
- Your BMI is 30 or more and you have either been recently diagnosed with type 2 diabetes or have poorly-controlled type 2 diabetes.
The roux-en-y gastric bypass may not be an appropriate option if you have had previous significant abdominal surgery.
Q: What are the different types of gastric bypass?
There are two main types of gastric bypass surgery – the (‘full’) roux-en-y gastric bypass or the (‘mini’) gastric bypass. The RNY bypass is held by many specialists as the ‘gold standard’ of weight-loss surgery having been performed for the last 50 years. The mini-gastric bypass is a relatively new procedure which is less technically demanding to undertake, but seems to be as powerful as the full bypass with respect to weight-loss and treating weight-related medical conditions. Mr Alkhaffaf will discuss both options with you during your consultation, and talk to you about whether either are suitable options for you.
Q: How much weight will I lose?
Two years on from surgery, the gastric bypass can help you lose an average of 3/4 of your excess weight. For example, if you are 5 foot 5 inches tall (165cm), the upper limit of a ‘healthy’ weight (a BMI of 25) is 70kg. Any weight above 70kg is termed as ‘excess weight’. If you weigh 110kg, your excess weight is 40kg (110kg-70kg). On average, gastric bypass surgery would help you lose approximately 30kg.
Weight loss results can vary significantly due to a number of factors including your genes and the lifestyle choices you make once you have had surgery. Our experts will discuss these factors with you during your consultation.
Q: What are the other benefits of bypass surgery?
The gastric bypass is a safe procedure undertaken using keyhole surgery. In addition to the dramatic associated weight loss, the gastric bypass is linked to marked improvements and resolution of many medical conditions including:
- Type 2 diabetes: Complete resolution in 70% of cases.
- High blood pressure: 70% of patients are able to reduce or stop medication.
- High cholesterol: 95% of patients show improvement or complete resolution of abnormally high cholesterol levels.
- Reflux: 95% of patients will notice marked improvement s or resolution of symptoms.
- Infertility: 95% of patients experience correction of underlying hormonal problems and restored fertility.
There are many other benefits including improvements in medical conditions such as asthma, back pain, liver disease, stress incontinence and psychological wellbeing.
Q: How long will I be in hospital?
The gastric bypass is a procedure which takes approximately 90 minutes to 2 hours to perform. It is done whilst you are asleep under general anaesthesia. In many cases, patients can go home after an overnight stay in hospital. A small proportion of patients require a second night in hospital.
Q: Are there any risks with the gastric bypass?
The gastric bypass operation is safe and effective and the risks associated with it are small. However no procedure or surgery is risk-free. Complications in the immediate period after surgery include:
- Internal bleeding
- Infection of the keyhole wounds
- Perforation: This includes inadvertantly making a hole in a section of bowel. This is rare and occurs in less than 1% of patients.
- Leak: When the new join between the stomach pouch and the intestine does not heal correctly, this is called an ‘anastomotic leak’. Again, this rarely occurs and happens in less than 1% of patients.
- DVT: A ‘deep veing thrombosis’ is another word for a clot in the leg. These clots can rarely also travel to the lung. We routinely prescribe you special stockings and blood thinning medication following your surgery to reduce the risk of this happening.
- Death: This is very rare and occurs in less than 1 in every 300 patients.
Some of the longer-term problems which may occur include:
- Poor absorption of vitamins: Your body needs certain vitamins and minerals to function properly, without which you can develop bone and nerve problems. We will ensure that you have all the advice necessary to supplement your vitamin requirements following surgery.
- Dumping syndrome: This is a collection of symptoms including diarrhoea, abdominal cramps, sweating, dizziness, headaches and fatigue which can occur after gastric bypass surgery. Some patients complain of dumping syndrome to varying degrees. Our weight-loss experts will advise you how best to manage this should it be a problem for you.
- Bowel hernia: Very rarely (in less than 1% of patients), the small intestines can twist causing a blockage and abdominal pain. Should this happen, further surgery would be required.
Q: Will I regain weight after surgery?
Weight loss and regain following surgery relies on many factors. It is influenced by your genes and the lifestyle choices you make following surgery. As such, surgery should be seen as a tool to aid you in your weight-loss journey.
Most gastric bypass patients eventually gain back about 8% of the weight they lose following surgery. 1 out of every 10 patients may find that they regain all of the weight they have initially lost with the bypass. The good news is however that most patients keep off at least 50% of their weight even 10 years following surgery.
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