Roux-en-Y Gastric Bypass, also known simply as gastric bypass, is one of the bariatric surgeries performed in the United States for the treatment of obesity or morbid obesity. While the adjustable gastric band, sleeve gastrectomy, and biliopancreatic diversion with duodenal switch are also conducted, gastric bypass is the most common procedure. Bariatric surgery is only indicated for patients who failed to lose weight with other methods, and like any other type of surgery, there are pros and cons of undergoing a gastric bypass.
During the procedure, surgeons start by creating a small pouch in the upper part of the stomach and stapling it to reduce the size of the organ. Next, the pouch is connected to the second part of the small intestine to provoke malnutrition of nutrients and calories. The surgery will facilitate weight loss, but does not cause direct loss of weight, which means that it is only a part of the treatment that includes life-style alterations, an healthy diet and regular exercise.
Gastric Bypass Pros and Cons: Advantages
Gastric bypass is considered the “gold standard” of bariatric surgery, which means not only that it the most commonly performed bariatric procedure worldwide, but also that it has been widely experimented and studied, leading to most effective results. According to the American Society for Metabolic and Bariatric Surgery (ASMBS), it is not uncommon for a bariatric surgery to reduce the size of the stomach, restricting the amount of food it can hold, but a gastric bypass also alters the food course, so that it won’t pass through a segment of small intestine that would normally absorb calories and nutrients.
Patients are proven to suffer alterations in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms that cause obesity-related type 2 diabetes. In addition, the surgery causes on average 60 to 80% long-term excess weight loss, which is superior to adjustable gastric band, while typical maintenance is higher than 50%. Other advantages include improvements in overall health, comorbidities, mobility, and increase in energy expenditure and quality of life.
Gastric Bypass Pros and Cons: Disadvantages
However, there are not only advantages associated with gastric bypass. The surgery is technically a more complex operation than the adjustable gastric band or laparoscopic sleeve gastrectomy, which can possibly result in greater complication rates. Patients submitted to Roux-en-Y gastric bypass have an approximate mortality rate of 2.5% 90 days after the procedure. Despite the fact that comorbidities like diabetes and high blood pressure may be minimized or cured, the worse they are prior to the surgery, more likely it is for the patient to suffer further complications.
Unlike the gastric band, but similarly to the other procedures, it is an irreversible surgery. Other disadvantage shared with biliopancreatic division with duodenal switch is that it is highly likely to cause long-term vitamin or mineral deficiencies particularly in vitamin B12, iron, calcium, and folate. In addition, it generally has a longer hospital stay than the AGB and it requires adherence to dietary recommendations, life-long vitamin/mineral supplementation, and follow-up compliance, as explained by the ASMBS.
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