Laparoscopic Gastric Bypass Surgery

Laparoscopic Gastric bypass procedures (LGB) are any of a group of similar operations that first divides the stomach into a small upper pouch and a much larger lower “remnant” pouch and then re-arranges the small intestine to connect to both. This surgery is relatively an older procedure but time tested. It is the surgery which has been followed for many years and is known as “Gold Standard ” for all bariatric surgery procedures. Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered ability of the intestine to absorb food.

The operation is prescribed to treat not only morbid obesity (defined as a body mass index greater than 40), but also type 2 diabetes, hypertension, sleep apnea, and other comorbid conditions.

Since 1991, major developments in the field of bariatric surgery, particularly laparoscopy, have updated some of the conclusions of the NIH panel. In 2004, a consensus conference was sponsored by the American Society for Bariatric Surgery (ASBS), which updated the evidence and the conclusions of the NIH panel. This conference, composed of physicians and scientists of both surgical and non-surgical disciplines, reached several conclusions, amongst which were:

• Bariatric surgery is the most effective treatment for morbid obesity.
• Gastric bypass is one of four types of operations for morbid obesity.
• Laparoscopic surgery is equally effective and as safe as open surgery.
• Patients should undergo comprehensive preoperative evaluation have multi disciplinary support for optimum outcome.

During surgery:

• Various laparoscopic (minimally invasive) surgical procedures have evolved in an effort to “shunt” or bypass a portion of the stomach. Four to six small openings (each less than on half to one inch long) are made in the abdomen (Laparoscopic Surgery). These openings allow the surgeon to pass a light, camera, and surgical instruments into the abdomen.
• Surgical instruments about the width of 5mm are placed into the abdomen to complete the surgery.
• In a Roux-en-Y gastric bypass, greater than 95 percent of the stomach is “bypassed” and a small portion (the size of an egg) remains functional. The remaining of the stomach pouch is then connected to the intestine. The remaining of the intestines are also bypassed so that only a small portion of intestine is available for absorption.

After surgery:

Most patients recover from surgery with no complications.

• The hospital stay is usually 3 to 5 days.
• You may be off work for 2 to 4 weeks.
• Once at home, you will need to follow specific eating guidelines. Your dieticians will assist you in understanding and adjusting to these guidelines.
• Regular follow-up visits are scheduled during the first year after surgery to check your overall physical and mental health, metabolism and nutritional status.
• Many patients will need plastic surgery (abdominoplasty) 1 to 2 years after weight loss to remove skin folds around the abdomen.