Laparoscopic Gastric Bypass as the name suggests is the Gastric Bypass surgery done by laparoscopic technology. Gastric Bypass, also known as Roux-en-Y Gastric Bypass is a bariatic surgery in which most of the part of the stomach is surgically stapled across the top to form a small stomach pouch as small as a walnut. This pouch is then connected to the small intestine, bypassing a large portion of small intestine. This causes the bypass of a major portion of the stomach and the duodenum. The food directly enters the jejunum. Thus, this process involves both the restrictive as well as malabsorption processes. Although food is not lower part of the stomach, it secretes digestive juices into small intestines and remains healthy.

Nowadays most of the surgeons perform this operation by using the laparoscope. It is a small tubular instrument with a camera attached through short incisions (4-5) in the abdomen. The tiny camera on the top of the scope allows the surgeon to see inside the abdomen. This is known as Laparoscopic Gastric Bypass.

But it should be remembered that everyone is not a candidate for laparoscopic gastric bypass surgery. If one is  in the age group of 18-60 years, the BMI of the person should be 40 or more, and have diabetes or hypertension then you may be a candidate for this type of surgery provided all the weight loss treatments have been tried and lost. If one is over 60 years of age and already have had a surgical procedure for weight loss take nicotine in any form then you are not an ideal candidate for Laparoscopic Gastric bypass surgery. In any case a proper pre-operative evaluation is required by the surgeon before he declares one as a candidate for this procedure.

There are many benefits attached with Laparoscopic Gastric Bypass but the most important one is that it drastically reduces the complications which might occur during an ‘open’ surgery. One experiences less pain and faster healing after the surgery. There is a huge weight loss in the first year after surgery, which makes other medical problems such as diabetes, hypertension, and coronary artery disease easier to treat or they may be eliminated all together. Laparoscopy reduces the changes of development of hernias.

Since the stomach pouch is reduced to the size of a walnut, during the first six months of the surgery, it is important to not to eat very fast or too much as it may cause vomiting or intense pain. During the first three to six months of the surgery one may experience body aches, tiredness, felling cold, dry skin, hair thinning and hair loss and mood changes due to rapid weight loss. One may experience It may take some time to get into a new diet and exercise regime. After about two years of this surgery one may expect to lose around 50-60 % of the excess weight.

Gastric bypass surgery is a common form of weight loss surgery that results in outstanding weight loss with minimal side effects. But once you undergo the gastric bypass surgery procedure you have to accept lifelong changes in your diet. The post-diet of gastric bypass surgery includes an adequate intake of protein, taking vitamin and mineral supplements including multivitamin, iron and calcium, B12 and avoiding sweets and fatty foods.

Types of gastric bypass surgery

In gastric bypass surgery, the surgeon takes off a large portion of the stomach leaving behind a tiny pouch. It is this small pouch that prevents overdose of eating as it can take very less amount of food. Moreover, with large parts of your stomach and small intestine bypassed, most of the nutrients and calories in the food do not get absorbed at all. This helps the person from gaining excess weight.

There are several types of bypass surgery operations.
They are:

§ Roux-en-Y gastric bypass [RGB] – this is a common surgery where a small stomach pouch is created by stapling part of the stomach together or by vertical banding. This reduces the amount of food to be taken. Then a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the duodenum as well as the first portion of jejunum. This causes reduced calorie and rapid nutrient absorption.

§ Extensive gastric bypass [biliopancreatic diversion] – in this complicated surgery, the lower portion of the stomach is removed. The small pouch that remains connected to the final segment of the small intestine completely bypasses both duodenum and jejunum.

People who undergo gastric bypass surgery always lose two-thirds of their excess weight within two years.

Risks of gastric bypass surgery

Gastric bypass surgery causes “dumping syndromes” where the stomach contents move too rapidly through the small intestine. The usual symptoms of gastric bypass surgeries include weakness, sweating, fainting, nausea, diarrhea, as well as inability to eat sweets.

People who undergo this procedure are at risk of:

§ Band erosion – the band closing off part of the stomach disintegrates

§ Pouch stretching – stomach gets bigger overtime, stretching back to its normal size before surgery

§ Leakage of stomach contents into the abdomen [acid can eat away other organs]

§ Nutritional deficiencies causing health problems

§ Breakdown of staple lines – band and staple fall apart, reversing procedure

Gastric bypass diet

Gastric bypass diet helps the patients to drop 50% to 90% of their overall excess fats. The diet is designed to bring about significant weight loss. It basically includes foods that are high in protein and low in fat, fiber, calories, and sugar. You should have lots of vitamins and minerals. Iron, vitamin, folate and calcium are the best nutrients for patients undergoing gastric bypass surgery.

You can undergo gastric bypass surgery only if you have been obese for at least 5 years, do not have a history of alcohol abuse, and do not possess untreated depression and range between the ages 18 to 65.

The contributions of Gastric Bypass Surgery in medical science can’t be exaggerated. Its effort in doing away with ailments like obesity and its subsequent complications has in a big way helped people do away with dire consequences of obesity.

The problem of obesity is often being ignored and we seldom realize that serious ailments like hypertension, Gastrosophageal reflux diseases, liver disease and also Atherosclerotic cardiovascular diseases often stems out of it. If not treated at an early stage, obesity can give rise to multiple ailments and thrust an individual towards degrading life.

In Gastric Bypass Surgery, the stomach is divided into to segments. The upper pouch is relatively smaller than the lower one. The surgeons then rearrange tissues of the small intestine and connect both the pouches. This results in reduced functional volume of stomach. This reduces the weight to a great extent and prevents comorbid conditions.

Roux-en-Y gastric surgery happens to be the most commonly practiced one in the United States. At first, a stomach bowl is created by stapling or bandaging parts of stomach. This restricts food consumption. After that, a Y shaped section of the small intestine is attached to the pouch so as to enable smooth flow of food through the duodenum as well as some part of jejunum. Nowadays, the surgery is performed with the help of laparoscope.

On the other hand, extensive gastric bypass surgery happens to be a more complicated procedure. In this case, the entire lower portion of the abdomen is removed and a part of the upper stomach remains connected to the small intestine. Thus the food passes through the duodenum and subsequently the jejunum. This procedure reduces weight to a great extent. But this surgery is rarely practiced as it results in mass nutritional deficiencies.

Though Gastric bypass surgery has successfully reduced chances of serious ailments, it is not free from drawbacks. Individuals having undergone this surgery complain of symptoms like nausea, sweating, fatigue and also diarrhea. This happens due to over dumping of stomach contents into the intestine. Sometimes this can result in dire consequences as outflow of acids into small intestine can substantially harm other organs.

Gastric Bypass Surgery happens to be one of the most complicated operations that have to be executed with proper care under vigilance of experienced medical practitioners. If not handled with care, the bandages and staple lines might fall apart giving rise to serious complications. Once a patient undergoes a gastric bypass surgery, he has to observe strict restrictions lifelong so as to avoid further complications.

For people who are heavily overweight, and suffering from severe or morbid obesity, dieting and exercise will often produce a short-term weight loss and can bring some marked health benefits. Any weight loss is however short-lived and the vast majority of people (between 80% and 95%) will regain their weight, and often put on further weight, relatively quickly. It is no surprise therefore that many morbidly obese individuals turn in the end to the gastric bypass as a lasting solution to their problem. But just how does the gastric bypass promote long-term weight loss?

To understand the mechanics of the gastric bypass we need to start by considering the normal digestive process.

When we eat, food passes initially into the stomach where it is broken down by a strong acid solution. Once the digestive process has been completed in the stomach, food moves into the duodenum, which is the first part of the small intestine, and bile and pancreatic juice is added to the mix to continue the process of digestion. It is here in the duodenum that iron and calcium are absorbed into the body.

Food then continues on down the small intestine, which is almost 20 feet in length, passing first through the jejunum and then through the ileum and it is here that the body extracts the bulk of the calories and nutrients contained in the food that we eat. Finally, any food particles that cannot be digested are passed into the large intestine where they are stored until they are passed out of the body.

We gain weight because the food that we eat contains more calories than we need to support the level of activity within the body and so the body, having burnt up the calories that it needs, stores any left-over calories as fat which is dispersed throughout the body.

Gastric bypass works by altering the body’s digestive process in one of two ways.

One form of gastric bypass (referred to as restrictive surgery) physically restricts the quantity of food that we can eat and so not only stops us from consuming more calories than the body needs but reduces our intake to fewer calories than are necessary and so forces the body to start burning off the reserves that it has laid down as fat.

The second form of gastric bypass (referred to as malabsorptive surgery) does not restrict the quantity of food that we can eat but creates a new passage for that food so that a substantial proportion of the small intestine is bypassed and the body is able to extract only a small number of calories. Once again this forces the body to dig into its fat reserves.

In many cases gastric bypass operations are in fact a combination of these two forms and will both restrict the intake of food and reduce adsorption by re-routing the food past much of the small intestine.

There are many variations of the gastric bypass and each has its advantages as well as its disadvantages. Some forms will be more suited to one individual than to another and in other cases it will be very much a matter of personal preference in consultation with your surgeon.

The gastric bypass is a powerful solution to the problem of obesity but it comes at a price and is not without both risk and complication. It is also important to understand that the gastric bypass is not in itself a magic cure for obesity and that you will need to learn to work with your new digestive system by adopting a whole new set of eating habits and a dramatic change to your lifestyle if you are to maintain the weight lost as a result of surgery.

Once the initial and virtually automatic weight loss has been achieved following the gastric bypass it is quite easy to abuse your new digestive system and to start putting the weight back on again.

Gastric bypass (also called bariatric surgery) closes off a large portion of the stomach, leaving only a pouch the size of an egg. Gastric bypass works by restricting food intake. Patients feel full after eating small amounts of food. Fewer calories are eaten and weight is lost. Gastric bypass patients typically lose 70% of their excess weight, most of it in the first year after surgery.

Gastric bypass surgery combines the creation of a small stomach pouch to restrict food intake and construction of bypasses of the duodenum and other segments of the small intestine to cause malabsorption (decreased ability to absorb nutrients from food).

There are two types of gastric bypass surgery: Roux-en-Y gastric bypass (RGB) and extensive gastric bypass (biliopancreatic diversion).

Roux-en-Y gastric bypass is the most common gastric bypass procedure performed in the U.S. First, a small stomach pouch is created by stapling part of the stomach together or by vertical banding. This limits how much food you can eat. Next, a Y-shaped section of the small intestine is attached to the pouch to allow food to bypass the duodenum as well as the first portion of the jejunum. This causes reduced calorie and nutrient absorption. This procedure can now be done with a laparoscope (a thin telescope-like instrument for viewing inside the abdomen) in some people. This involves using small incisions and generally has a more rapid recovery time.

In extensive gastric bypass – a more complicated gastric bypass operation – the lower portion of the stomach is removed. The small pouch that remains is connected directly to the final segment of the small intestine, thus completely bypassing both the duodenum and jejunum. Although this procedure successfully promotes weight loss, it is not as widely used because of the high risk for nutritional deficiencies.

Gastric bypass operations that cause malabsorption and restrict food intake produce more weight loss than restriction operations, which only decrease food intake. People who have bypass operations generally lose two-thirds of their excess weight within 2 years.

There are risks associated with gastric bypass surgery. People who undergo this procedure are at risk for: pouch stretching (stomach gets bigger overtime, stretching back to its normal size before surgery), band erosion (the band closing off part of the stomach disintegrates), breakdown of staple lines (band and staples fall apart, reversing procedure), leakage of stomach contents into the abdomen (this is dangerous because the acid can eat away other organs), nutritional deficiencies causing health problems.

Gastric bypass operations also may cause “dumping syndrome,” whereby stomach contents move too rapidly through the small intestine. Symptoms include nausea, weakness, sweating, faintness, and, occasionally, diarrhea after eating, as well as the inability to eat sweets without becoming extremely weak. Gallstones can occur in response to rapid weight loss. They can be dissolved with medication taken after the surgery.

The limited absorption of vitamin B12 and iron can cause anemia. The lack of calcium absorption can cause osteoporosis and metabolic bone disease. People who undergo this procedure are required to take nutritional supplements that usually prevent these deficiencies. The more extensive the bypass operation, the greater is the risk for complications and nutritional deficiencies. People who undergo extensive bypasses of the normal digestive process require not only close monitoring, but also lifelong use of special foods and medications.

Low carbs, the bottom line: you may lose weight quicker on a low-carbohydrate diet than on a diet to cut calories. However, don’t expect to lose as much weight as diet books say you will and remember that the risks of heart disease, stroke, cancer, and osteoporosis for people on low-carb diets have not been tested. There’s plenty of research that shows the way to go is moderation in eating a diet rich in fruits, veggies, beans, whole grains, seafood, poultry, and low-fat dairy products.