Laparoscopic Gastric Bypass

The American Society for Bariatric Surgery and the National Institutes of Health recognize the gastric bypass as the leading weight loss surgery. This procedure is widely performed in the U.S. and offered at the INTEGRIS Health Weight Loss Center in Oklahoma City.

The Procedure

In this procedure, stapling creates a small (15 to 20cc) stomach pouch. The remainder of the stomach is not removed but is completely stapled shut and divided from the stomach pouch.

How it Works

The outlet from this newly formed pouch empties directly into the lower portion of the jejunum (second part of the small intestine), thus bypassing calorie absorption. This is done by dividing the small intestine just beyond the duodenum for the purpose of bringing it up and constructing a connection with the newly formed stomach pouch.

The other end is connected into the side of the Roux limb of the intestine creating the "Y" shape that gives the technique its name, Roux-en-Y. The length of either segment of the intestine can be increased to produce lower or higher levels of malabsorption.

Advantages of Laparoscopic Gastric Bypass

• Effectively controls food intake.
  
• Dumping syndrome, causing control of sweet intake.
  
• Reversible in an emergency, though this procedure should be thought of as a permanent.
  
• The average excess weight loss after the procedure is generally higher in a compliant patient than with purely restrictive procedures.
  
• One year after surgery, weight loss can average 77 percent of excess body weight.
  
• Studies show that after 10 to 14 years, 50-60% of excess body weight loss has been maintained by some patients.
  
• A study of 500 patients showed that 96% of certain associated health conditions studied were improved or resolved, including back pain, sleep apnea, high blood pressure, diabetes and depression.

Disadvantages of Laparoscopic Gastric Bypass

• Because the duodenum is bypassed, poor absorption of iron and calcium can result in the lowering of total body iron and a predisposition to iron deficiency anemia.
• Bypassing the duodenum has caused metabolic bone disease in some patients, resulting in bone pain, loss of height, humped back and fractures of the ribs and hip bones. All of the deficiencies mentioned above, however, can be managed through proper diet and vitamin supplements.
• A chronic anemia due to Vitamin B12 deficiency may occur. The problem can usually be managed with Vitamin B12 pills or injections.
• In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched and/or if it is initially left larger than 15 to 30cc.