Laparoscopic Roux-en-Y Gastric Bypass
The laparoscopic Roux-en-Y gastric bypass procedure involves making several small incisions through which laparoscopic instruments are inserted to perform the surgery. The procedure is designed to make a small reservoir or pouch for food at the upper end of your stomach with the capacity of about 30mL. This pouch is connected to the small intestine by a new anastomosis, or join. The outlet of this join is about 4 cm in diameter. Ingested food therefore bypasses the majority of your stomach, which remains alive and undisturbed in the abdominal cavity. Put another way, the majority of your stomach does not have food passing through it. As a result there is an associated prolonged decrease in appetite and sometimes even a temporary aversion to food. This procedure is predominantly a restrictive procedure and achieves weight loss by limiting the amount of food or liquid that can be taken at any time. There is a small aspect of malabsorption, which requires you to take vitamins and supplements for the rest of your life. The procedure results in rapid weight loss initially which stabilises over a 12 to 18 month period. In the initial postoperative period it can take some time for you to learn how your new stomach behaves and you can have problems with some discomfort after eating and occasional vomiting.
Following gastric bypass you may experience an intolerance to certain types of food, usually fatty greasy foods, dairy products, and/or sweets (lollies) which may cause unpleasant symptoms similar to sea sickness such as sweating, nausea, shaking, abdominal pain and/or diarrhoea which lasts from a few minutes to an hour. This is known as “dumping” syndrome. Some patients regard this as a useful side effect as it reinforces their inability to consume high calorie foods. I would prefer that you concentrate on developing a healthy dietary intake post surgery.
You will lose a large amount of weight rapidly in the first few months following gastric bypass. Although this is something you are looking forward to, it is important that you lose this weight in a healthy way to avoid side effects such as fatigue and hair loss. It is important that you follow the dietary recommendations given to you by Michelle, our Dietician. Your chance of achieving your weight loss goals is enhanced if you follow our bariatric programme after surgery. Like any bariatric procedure, there are ways to defeat the surgery and fail to lose weight or fail to achieve your maximum weight loss. If you overeat on a regular basis you can stretch your pouch or dilate your anastomosis leading to eventual weight gain. It is also possible to consume sufficient amounts of high calorie liquid or food such that you do not lose weight. In general, if you choose a balanced menu, high in protein, eaten at normal times and incorporate regular exercise into your daily routine, the tool that is gastric bypass will allow you to lose weight and keep it off in the longer term.
The Roux-en-Y gastric bypass is a common longstanding procedure performed around the world, particularly in the United States of America. Weight loss with the Roux-en-Y gastric bypass averages between 65 to 75% of excess weight. The health problems associated with excess weight and quality of life are improved and these benefits can be achieved well before you have achieved your maximum weight loss.
Other bariatric procedures available in the practice including laparoscopic gastric band and laparoscopic sleeve gastrectomy. All of these procedures are designed as tools to help you to lose
your excess weight, making you healthier and hopefully improving your quality of life. The gastric band restricts the size of your stomach to about 30mL with an adjustable silicone band. The band can be adjusted by injecting saline into a port, which sits underneath your skin below your breastbone. Weight loss occurs by restricting your dietary intake. The stomach is not altered in any way. It is the safest and least invasive of the bariatric procedures on offer. Weight loss is more gradual than the other procedures and, as with all the procedures, weight loss can be circumvented by consuming sufficient amounts of high calorie liquid or food. In addition, having the band either too lose or too tight can lead to long-term problems. When closely monitored and adjusted appropriately, the gastric band can achieve weight loss on the average of 65% excess weight over a two to five year period.
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