Gastric Bypass Surgery is one of the most common and effective surgical procedure for weight loss. The surgery can help reduce excess body weight by about 70%. Though there are many variants of this procedure, the most popular one is known as Roux-en-Y gastric bypass (RYGB) surgery.
In this procedure the stomach is divided into a small upper pouch and a larger bottom pouch. The small upper pouch is then connected to the lower part of the small intestine. The severed upper end of the small intestine is then connected to the connecting portion of the stomach pouch and lower part of the small intestine. This is to help in the flow of digestive juices to aid in digestion. In this procedure a major part of the digestive system is bypassed. The benefits of this procedure are lesser intake of food and lesser absorption of calories into the system.
Gastric bypass surgery is an effective weight loss surgery for severe obesity. It also helps to correct conditions associated with obesity like hypertension, sleep apnea, Type 2 diabetes and high cholesterol.
Gastric Bypass Surgery procedure
A gastric bypass surgery procedure is done in 2 stages. The duration of surgery is around 4-5 hours.
The steps involved in the surgery are
- Administration of general anaesthesia
- Division of the stomach into two parts- The stomach is divided into two parts using surgical staples. The upper pouch will be only ten percent of the actual stomach size and will have a capacity of only 30 ml.PO
- Connection of the lower part of the small intestine to the upper stomach pouch
- Connection of the other end of the small intestine to the part that connects the upper stomach pouch to the lower end of small intestine.
- Suturing of surgical incisions
The duration of a gastric bypass surgery is about 4 hours. The average duration of hospital stay will be around a week.
Gastric bypass surgery risks and complications
Gastric bypass surgery is a very safe procedure with a very high success rate. However, like any other major surgical procedure, there are few risks or complications associated with it.
These risks could be short term or long term.
Short term risks are
- Severe blood loss during surgery
- Formation of blood clots,
- Leakage from the newly connected parts
- Breathing problems
- Adverse reaction to anaesthesia or other medications
Long term complications can include:
- Bowel obstruction- This happens due to a condition called as internal hernia where there is an ingrowth in the small intestine. The symptoms are pain, swelling in the abdomen, vomiting etc
- Dumping syndrome – This is a condition where the food, especially those containing sugars, stays in the stomach only for a very short time and rapidly empties into the small intestine. The symptoms are nausea, vomiting, diarrhoea, abdominal cramps, flushing of the skin, increased heart rate etc. Hypoglycaemia or low blood sugar may occur in certain cases.
- Bowel changes like diarrhoea, constipation etc
- Formation of kidney stones
- Formation of gastric ulcers
- Malnutrition due decreased absorption of vitamins, minerals etc.
- Unexplained body aches, dryness of skin etc may occur in the initial months after bariatric surgery. Mood changes or other emotional problems may occur during the first couple of months. These may not require any treatment and usually subsides by itself.
Most of these side effects can be managed through a proper diet plan and rehabilitation therapy with mild exercises.
Who can undergo a gastric bypass surgery?
A person may opt for a gastric bypass surgery when, conventional weight loss methods fail to reduce weight as required.
A person is a candidate for gastric bypass surgery if he/she is either
- Morbidly obese with a BMI over 40
- Severely obese with a BMI over 35 and have other comorbid conditions like hypertension, sleep apnea, Type 2 diabetes and high cholesterol
Other factors considered for bariatric surgery
- Age- The ideal age for a gastric bypass surgery is between 20 and 50. People older than this may undergo surgery if there are no disease conditions that preclude a surgery
- Diet- A person undergoing a gastric bypass surgery will have to be on a specific diet for the rest of the life. Only those with the will to undertake this may opt for a bariatric surgery. Otherwise there could be severe complications
- Intake of dietary supplements- Since there is decreased absorption of nutrients after a gastric bypass surgery, one may have to take certain dietary supplements, especially vitamins, to prevent malnutrition.
- Irreversibility of the procedure- A gastric bypass surgery though reversible under certain specific conditions, should be done only after a careful analysis of its pros and cons as reversing the surgery may be complicated or risky.
Gastric bypass surgery benefits
- A gastric bypass surgery helps reduce the excess weight in the body by around 70%.
- Individual body conditions have a major impact in the success of the surgery. The average weight loss after one year is around 60 %, and an average five-year weight loss is about 50%.
- The most important benefit is in the form of relief from obesity linked health conditions like hypertension and sleep apnea.
- The long- term success of the surgery depends on the adherence to the prescribed diet. Those going back to their old food habits will gain weight even after surgery.
Diet after bariatric surgery
- A liquid diet without spices or flavours will have to be taken in the first week after surgery
- Thicker liquids like soups, broth, milk etc can be added to the diet during the second week.
- After 2 weeks, soft or mashed foods like cottage cheese, scrambled eggs, cooked vegetables and fruits can be added to the diet.
- Solid foods may be slowly test-started after 4-6 weeks after surgery
- A proper diet is very critical after a bariatric surgery to avoid complications and maintain the body weight within normal limits.
Gastric bypass surgery in India
Gastric bypass surgery in India costs a fraction of what it does in most countries around the world.
Gastric bypass surgery cost will include
- Pre-operative diagnostic tests
- Cost of surgery
- Hospital stay
Gastric bypass surgery is a safe surgery with few chances of complications. But at times unforeseen complications may develop that may need further medical treatment. This can increase the treatment cost to an extent.
Patients coming from other countries for gastric bypass surgery in India will incur certain additional costs. They are visa charges, accommodation outside the hospital during their stay in India, flight tickets etc.
Even then the cost of gastric bypass surgery in India is far less than that of other countries.