The term “gastric bypass” is often used to refer specifically to the Roux-en-Y gastric bypass procedure. Technically, gastric bypass surgery refers to a group of weight loss procedures that decrease the size of the stomach and allow food to bypass most of the stomach and part of the small intestine. By far the most common form of this procedure is the United States is the Roux-en-Y Gastric Bypass. In addition to the Roux-en-Y, there is a Mini Gastric Bypass. The Mini Gastric Bypass is a more technically simple procedure, but there is no data on its long-term success or safety, so most bariatric surgeons do not perform it, and most insurance companies will not cover it. The information below is specific to the Roux-en-Y Gastric Bypass surgery.
How it Works
Gastric bypass surgery makes the stomach smaller by creating a small pouch (roughly the size of a golf ball) at the top of the stomach using surgical staplers. The small stomach pouch is connected directly to the middle portion of the small intestine, bypassing the rest of the stomach and the upper portion of the small intestine. Food no longer travels through the remaining larger part of the stomach (referred to as the ‘gastric remnant’). This change to the digestive system reduces hunger and limits the amount that is eaten and digested, which promotes weight loss.
Gastric bypass surgery can be performed either through the traditional “open” method – which involves making a large incision in the abdomen – or it can be performed laparoscopically. Laparoscopic surgery is also known as Minimally Invasive Surgery. Small incisions are made in the belly, through which a video camera and other specialized surgical tools can be placed. Laparoscopic surgery usually results in shortened recovery time, fewer complications, and less postoperative scarring. Most bariatric surgeons are now performing the Roux-en-Y bypass laparoscopically.
After undergoing a gastric bypass surgery, patients usually stay in the hospital for 2-3 days. The recovery period for the bypass is slightly longer than with the adjustable gastric banding procedure because it is more invasive. Many patients who have sedentary jobs often return to work within 2-4 weeks, while patients with more physically demanding jobs may be out of work for 4-6 weeks.
Weight Loss Trends
Patients with a gastric bypass generally lose weight rapidly and continue losing weight in the year following the procedure, at a rate of about 10 pounds a month. On average, gastric bypass patients lose 50 to 70 percent of their excess body weight. Additionally, obesity-related medical problems such as diabetes and obstructive sleep apnea generally improve after gastric bypass surgery.
The National Institutes of Health (NIH) has published guidelines on bariatric surgery. Patients are potential candidates for surgery if they have a BMI of 35 or over if they have a comorbidity such as type 2 diabetes, hypertension, obstructive sleep apnea, or high cholesterol. In addition, patients with a BMI of 40 or greater are potential candidates for surgery, regardless of the presence of other medical conditions.
Gastric bypass surgery generally costs more than gastric band surgery. Many insurance companies, including Medicare, will cover part of the cost of surgery, and the price will vary regionally as well as by practice. Some practices will include the cost for follow-up care, support groups, nutritional counseling and other services in their quoted price. Be sure to ask exactly what is covered in the cost of surgery when you are comparing options. As with anything, the ‘cheapest’ surgery option does not mean it’s the best choice.
All surgeries have risks of complications. Potential complications of a gastric bypass include nausea and vomiting, vitamin and mineral deficiency, intolerance to certain foods, gallstones, hernias at incision sites, ulcers and bowel obstructions, as well as rare, but more serious risks, including blood clots, leaking at one of the staple lines in the stomach.
Other weight loss surgery options: