Laparoscopic Gastric Bypass Surgery
Laparoscopic gastric bypass surgery is commonly used nowadays for gastric bypass operations. It has a number of advantages over the traditional open surgery:
The incisions are small for any significant infection to occur. In addition, the risk of developing a hernia is less than one percent.
The risks of infection, wound problems and hernias are about 30 percent with the traditional open surgery operation.
The Laparoscopic Gastric Bypass Surgery Operation
During laparoscopic gastric bypass surgery, your stomach is cut to form a small pouch (30g or 1 ounce) and the remaining stomach and first 1-2 feet of small intestine are bypassed.
In the standard gastric bypass, the amount of intestine bypassed is not enough to cause inadequate absorption of nutrients from the intestinal tract.
However, the bypassed portion is very good at absorbing calcium and iron.
Therefore, anaemia and osteoporosis are common long-term complications of the gastric bypass. They must be prevented with lifelong mineral supplementation.
Other deficiencies likely to occur include thiamine and Vitamin B12. Lifelong follow-up with a bariatric program is mandatory to monitor and prevent nutritional complications.
Most surgeons recommend specific supplements to prevent these long-term complications.
The gastric bypass does not require removal of any part of the stomach. The unused stomach survives well with no long-term problems.
The unused stomach produces important enzymes such as intrinsic factor, which is crucial in the absorption of Vitamin B12 and is only made in the stomach.
The most commonly performed bypass is called the proximal bypass. It involves little or no malabsorption.
Some surgeons modify the gastric bypass to incorporate a significant amount of malabsorption of calories and nutrients for increasing weight loss. This modification is called a distal gastric bypass. It has more nutritional complications than the proximal gastric bypass.
It is up to the surgeon to decide if long-term weight loss is better and risk the malabsorptive complications.
Many surgeons reserve the distal bypass for very special circumstances. A lot of weight loss has to be weighed against likely complications.
The length of hospital stay after any of these operations is 2–7 nights.
How Gastric Bypass Surgery Works
The standard gastric bypass and laparoscopic gastric bypass surgery work in a complex manner. After the surgery, patients experience major changes in their behaviour.
Most patients do not get hungry often and even then, the hunger is short-lived. Patients are able to enjoy healthy foods. They also lose their usual food cravings.
Patients rarely feel deprived of foods. These behavioural changes are partially due to alterations in the hormones and neural signals produced in the GI track that communicates with the hunger centres in the brain.
The small size of the stomach restricts the volume of food people eat. The decrease in hunger and the feeling of fullness accounts for most of the weight loss after a gastric bypass.