What Is Gastric Bypass Surgery?
A surgical approach reducing the size and volume of the stomach and making connections with the small intestine is included in the gastric bypass surgery. The primary aim of the surgery is to bypass a major portion of the stomach so that food is contained only in a minor portion and then is sent to the small intestine directly for further processing. Thus, the individual feels full after having eaten less since only a small portion of the stomach will be available for storage of food. The procedure involves a thorough diagnosis of obesity, a proper planning and execution and a good post operative care and instructions.
Causes of Obesity:
A lot of factors combined lead to obese conditions. They can be either of the following:
- Lack of exercise, lethargic lifestyle, sedentary job
- Many a times, obesity runs in the family. This can be attributed to a genetic inheritance
- Excessive alcohol consumption, eating junk food for main meals, indulging into oily and fried food at odd hours leads to slowing down of the metabolism further adding to fats in the body.
- Certain medications such as anti depressants, anti epilepsy and corticosteroids are known to cause water retention in the body and thus add to the existing weight of the individual.
Signs and Symptoms of Obesity:
- A increased heart rate/pulse, high blood pressure, kidney problems, high blood sugar levels
- Excessive pressure on weight bearing joints, pain and difficulty in walking
- Breathlessness, lethargic feeling
- Increased body mass index, increased body weight, reduced metabolic rate.
Diagnosis of Obesity:
The body mass index BMI is used for the classification of obesity. To obtain the BMI, the weight of the individual is divided by the height. Thus the BMI is given in kg/m2 .There are five classes for BMI as follows:
- <18.5 is considered as underweight
- 18.5 to 25 is considered as normal
- 25 to 30 is obese
- 30 to 35 is class I obese
- Value 35 to 40 is class II obese
For a gastric balloon surgery, class I and II individuals are considered as ideal. In such cases heavy exercise regimes and diet monitoring fail to help reduce the weight and thus an alternative plan needs to be executed. Here comes the surgical option in play.
Treatment Procedures for Gastric Bypass Surgery:
An incision is made in the upper abdominal area. Once access to the stomach is achieved, a small thumb sized pouch in the upper part of the stomach is ligated and the remaining major portion of the stomach is bypassed. Food can only be stored in the thumb sized area and cannot reach the other portions of the stomach. Thus the patient eats as much as the capacity of the mini stomach is. Hence the patient feels full by eating very less. This procedure can be said to be creating a partition between the stomach, dividing it into two compartments.
Next in line is the reconstruction of the connection between the stomach and the small intestine. The bypassed part of stomach is left as it is with the upper small portion opening into the upper part of the small intestine. Once the bolus from the mouth reaches the upper part of the stomach, it is acted upon by the peptidases and HCl and further transferred to the small intestine for processing and re absorption of nutrients. When all the mandatory connections are established, suturing is done and the wound is closed.
There are certain variants to the traditional method. These are as follows:
- Gastric bypass, Roux en Y (proximal): This by far is the most commonly used method for the bariatric surgery. It involves the formation of a Roux Y shaped limb in the small intestine curvature. The arm of Y begins in the proximal (upper) part of the small intestine which directly falls below the lower portion of the stomach. Thus in a way, portions of the small intestine are also bypassed.
- Gastric bypass, Roux en Y (distal): The average length of the small intestine is 10 metres. In this method, the Y connection is moved further down in the small intestine. Thus, the amount available to fully absorb nutrients is progressively reduced, traded for greater effectiveness of the operation. The Y-connection is formed much closer to the lower (distal) end of the small intestine. The unabsorbed fats and starches pass into the large intestine, where bacterial actions may act on them to produce irritants and malodorous gases.
- Mini gastric bypass: In this method, a line for food passage is constructed along the lesser curvature of the stomach. This can be considered as an alternative to the Roux en Y procedure.
- Endoscopic duodenal-jejunal bypass: This procedure involves placement of an implant in the upper part of small intestine (duodenum) and the middle portion of the small intestine (jejunum) so as to enable a smooth pathway for the passage of food. Since the major portion of stomach is bypassed, the food should fall directly into the implant line from the smaller portion of the ligated part of the stomach.
Complications And Risk Factors Associated With Gastric Bypass Surgery:
- Infection of the wound can be a serious condition, further complicating the healing
- Scarring of the suture can also occur
- Internal bleeding, hemorrhage can occur after the Roux en Y procedures
- Hernia may result due to a disturbance in the internal arrangement of the bowel
- Excessive scarring can lead to bowel obstruction
- Multiple ulcers can develop considering the bacterial micro flora are unavailable for the digestion since major portions of the stomach as well as that of the small intestine are bypassed.
- Thus, it is very common to see nutritional deficiencies such as that of protein, vitamin B12, zinc to occur in such cases
- Abdominal pain, diarrhea/constipation is also not uncommon to find in such individuals
Am I Good Candidate For Gastric Bypass Surgery?
You are an ideal candidate for a gastric bypass surgery, if any of the following factors are worrisome for you:
- You put in tremendous amount of time and energy into working out, but all in vain
- You just cannot seem to be finding it easy to monitor your diet
- All the efforts that you ever take, do not seem to help you in reducing your extra kilos!
It is advisable to keep the patient under observation for a period of 3 to 5 days. However even after getting a discharge, the patient will take a maximum of 5 to 6 weeks time for a complete recovery and get back to the routine lifestyle.
A gastric bypass surgery shows 70 percent success in the weight loss up to 5 years, after which it may go down to 60 to 65 percent.
Benefits of Gastric Bypass Surgery:
A gastric bypass surgery will help you in the following manner:
- Help you feel very full, even after eating very less
- Thus, you are trained to eat less, helping you put on less weight
- You can manage getting into a light exercising regime since the appetite now can be taken care of
You may be required to pay an amount in the range of 1.25 to 2.75 lakh for the surgical procedure alone. The hospital stay fee, medication fee may vary. This too is almost 35-40 percent lesser as compared to the amount you will be expected to pay in the States/UK
Why choose India?
Team MedcureIndia being the leading stations for medical tourism, highly recommends bariatric procedures such as gastric bypass surgery in India owing to the highly efficient professionals, equipments and low costs. You can blindly follow the Indian team for your weight loss programme and be rest assured that all will be taken care of.