Other Procedures
Gastric Bypass
The gastric bypass involves a small pouch being created at the top of the stomach by dividing the stomach. The small bowel then is joined to this pouch to bypass the stomach and the upper small bowel. This restricts the amount that can be eaten before experiencing discomfort and bypasses the major site in the bowel of food absorption. This is a permanent procedure, which cannot be reversed without major surgery. Gastric bypass has long been the gold standard for weight loss surgery and is still the most commonly performed weight loss operation in the US, although its frequency in the US is decreasing while the frequency of lap band surgery is increasing.
Potential advantages of the Gastric Bypass include
- Demonstrated rapid weight loss which has been shown to be maintained over the long term in most patients
- Improved blood sugar control in diabetics due to bypassing food absorption in the small bowel. This is on top of any improved blood sugar control with weight loss and most diabetics can cease or reduce their medication immediately after surgery.
- A low risk of long term complications requiring reoperation.
Concerns about the Gastric Bypass include
- Gastric bypass has a risk of serious complications with surgery including leaking from the divided stomach and bowel joins. The laparoscopic approach has made this procedure a safer option compared to performing the operation through an open incision although the risk of surgery still remains higher than lap band surgery.
- The gastric bypass produces a state of chronic malabsorption of many vitamins and minerals as well as calories. Life long mineral and vitamin supplements are needed as is long term follow-up to measure nutrient levels.
- Eating food that is high in sugars and fats leads to a condition called ‘dumping’, which can result in a rapid drop in blood sugar, nausea, vomiting and diarrhoea. This can generally be avoided by eating the right foods but some patients will experience troublesome dumping after surgery.