It constitutes one of the best surgeries to control severe obesity and is considered the gold standard bariatric operation today. It allows the patient to lose weight in a very significant way, while keeping it off on the long term. Patients will be able to have a diet without many restrictions except for the size of their meals. This translates into a balanced diet with small rations that will leave the individual satisfied. The laparoscopic gastric bypass surgery consists in creating a small stomach that will make the patient feel full with small amounts of food. The small bowel is connected directly to this reduced stomach that we have created in order to slightly decrease the absorption of some food and alter the tolerance to others (less tolerance to sweets, sugar, etc.) This usually leads to a greater weight loss than the adjustable gastric band. Gastric bypass may permit a 70% reduction on these patients' overweight. Gastric bypass is an excellent means to a significant weight loss. To obtain optimum results, it is necessary that the patient follow some dietary recommendations. Food intake during the first two weeks after surgery will be liquid, followed by soft meals the next two weeks and progressively acquiring a normal diet in small amounts. Since the normal absorption route of food is altered with this surgery, patients need to permanently take dietary supplements (vitamins and calcium). In order to obtain a permanent significant weight loss, patients must avoid intake of sugar and other sweets after surgery. This food will not be tolerated by some patients and will present a phenomenon called the "dumping syndrome." Liquor consumption must be limited, since it is an important source of calories that can impede weight loss or even cause weight gain in the long term. Nevertheless, even though gastric bypass is the best surgical choice for most people with severe and morbid obesity, permanent modifications in their eating habits must be instituted.
What is the dumping syndrome?
Approximately 60 to 70% of the patients taken to gastric bypass develop a moderate degree of sugar and sweet intolerance. This event is called the dumpling syndrome and is determined by a decrease on the levels of blood glucose (hypoglycemia) when the patient eats sugar. It's symptoms are: dizziness, sweat, tremor, and weakness. These are very uncomfortable symptoms and the way to avoid them is by not consuming sweets or any other product with sugar. Patients with gastric bypass who present the dumping syndrome can improve by avoiding sugar intake. Patients taken to gastric bypass must take vitamin and calcium supplements permanently and indefinitely, since their absorption is altered with the operation.
Advantages of laparoscopic gastric bypass:
The procedure is done through laparoscopy, which means that the surgery is made through very small incisions in the abdominal wall where a telescope attached to a camera is passed through. No big incisions on the abdomen are necessary, like it was done in the traditional "open" method. In terms of effectiveness, this surgery is superior to the gastric banding and the vertical banded gastroplasty.
Risks of laparoscopic Gastric Bypass:
The reduction in the iron, calcium, and vitamin B12 absorption can produce deficiencies. The fast passage of food from the stomach to the small intestine may produce a Dumping Syndrome, especially if the patient consumes too much sugar. In general, It is not considered an important risk for health, but it can be uncomfortable for the patient, by producing inconvenient symptoms like nauseas, weakness, perspiration and dizziness after eating. This can become a positive factor for weight loss, since it will force the patient not to consume this type of food in order to avoid the symptoms. The closed portion of the stomach located in the distal part and the duodenum will never receive food, but they still produce gastric juices, without atrophy of the organ. They cannot be visualized through endoscopy. In order to evaluate these organs, if necessary, radiological images or a laparoscopic endoscopy can be performed. In some cases, the effectiveness of the procedure can be reduced if the small stomach becomes dilated. This can happen when patients have large food intake even though they already feel full. The risks of the procedure include infection, bleeding, and adverse reaction to medicationsas in any other surgical operation. Leaks and stenosis at the intestinal union can also occur. Over all, the advantages of gastric bypass for patients with morbid obesity overrule its risks. The frequency of complications is notably less when the procedure is practiced by a group of experienced surgeons. At Clinica de la Obesidad we have performed more than 2500 bariatric operations. Most of them have been Laparoscopic Gastric Bypass and sleeve gastrectomy, with a very low incidence of complications, making it a safe procedure.