Roux-en-Y gastric bypass, almost known simply as “gastric bypass,” is the most common type of bariatric surgery for the treatment of obesity, while adjustable gastric banding, sleeve gastrectomy and biliopancreatic diversion with duodenal switch are also performed in the United States. Surgery is often the last resort for obese or morbidly obese patients who have previously tried but failed to lose weight with other medically supervised weight loss programs like behavioral alterations, pre-packed substitution meals, or pharmacotherapy.
During the procedure, a new stomach pouch is created, reducing the size of the organ, and the smaller stomach is reconnected directly to the middle portion of the small intestine in a part of the organ called the jejunum. Therefore, not only does the capacity of the stomach become smaller, but the food also bypasses the second part of the stomach and upper part of the small intestine, the duodenum. The gastric bypass results in a faster feeling of satiety and malabsortion of nutrients and calories in the intestine.
Recovery From a Gastric Bypass Surgery
While the surgery is taking place, patients remain under general anesthesia, and when they wake up usually have a drip in the arm to provide liquids to the body, as well as a urinary catheter to drain urine from the bladder. Patients need to stay in the hospital about a day, but the hospital stay may be prolonged to ensure that there were no complications to the surgery. The tubes will be removed as the patient is able to get out of bed and blood-thinning medication and compression stockings may be used to prevent blood clots. After going home, patients will start a liquid diet and gradually transition to solid foods in order to let the stomach heal and according to the doctor’s recommendations.
Returning to normal activities will happen three to five weeks after the surgery. Patients will notice alterations in their normal digestive system and bowel movements, which is normal, but need to pay attention to side effects that were discussed by the physician and can be indicators of complications. However, the patients will start regular follow-up medical visits, during which the recovery process is discussed. In addition, since the gastric bypass causes the food to bypass the part of the intestine where minerals and vitamins are absorbed, patients may need to take supplements.
Gastric Bypass Recovery Compared to Other Procedures
The American Society for Metabolic and Bariatric Surgery (ASMBS) states that the gastric bypass “is considered the ‘gold standard’ of weight loss surgery and is the most commonly performed bariatric procedure worldwide.” The advantages of the procedure include the significant long-term weight loss of 60 to 80% of the excess weigh loss. However, both the sleeve gastrectomy and biliopancreatic are more effective in achieving and maintaining weight loss. It may also lead to conditions that increase energy expenditure, and produces favorable changes in gut hormones that reduce appetite and enhance satiety.
In addition to weight loss after the surgery, gastric bypass also has a typical maintenance of more than 50% excess weight loss, which is similar to a sleeve gastrectomy but superior to an adjustable gastric band. However, since it is a surgery more complex than the sleeve gastrectomy and the gastric band, it has higher complication rates, but lower than the biliopancreatic diversion with duodenal switch. Patients may experience long-term vitamin or mineral deficiencies particularly deficits in vitamin B12, iron, calcium, and folate. In addition, it has average longer hospital stays than a gastric banding, but less prolonged than a sleeve gastrectomy or biliopancreatic diversion. All of the procedures require adherence to lifestyle alterations, and follow-up compliance.