In recent years, better clinical understanding of procedures combining restrictive and malabsorptive approaches has increased the choices of effective weight loss surgery for thousands of patients. By adding malabsorption, food is delayed in mixing with bile and pancreatic juices that aid in the absorption of nutrients. The result is an early sense of fullness, combined with a sense of satisfaction that reduces the desire to eat.
According to the American Society for Metabolic and Bariatric Surgery and the National Institutes of Health, Roux-en-Y gastric bypass is the current gold standard procedure for gastric bypass surgery. It is one of the most frequently performed weight loss procedures in the United States. In this procedure, stapling creates a small stomach pouch. The remainder of the stomach is not removed, but is completely stapled shut and divided from the stomach pouch. The outlet from this newly formed pouch empties directly into the jejunum, thus reducing 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.
The length of either segment of the intestine can be decreased or increased to produce lower or higher levels of malabsorption.
- The average weight loss after the Roux-en-Y procedure is generally higher in a compliant patient than with a purely restrictive procedure such as adjustable gastric banding.
- One year after surgery, weight loss can average 60 to 80 percent of excess body weight.
- Studies show that after 10 to 14 years, 50 to 60 percent of excess body weight loss has been maintained by some patients.
A recent study of 500 patients showed that 96 percent of certain associated health conditions studied (back pain, sleep apnea, high blood pressure, diabetes and depression) were improved or resolved.
- 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. This is a particular concern for patients who experience chronic blood loss during excessive menstrual flow or bleeding hemorrhoids. Women, already at risk for osteoporosis that can occur after menopause, should be aware of the potential for heightened bone calcium loss.
- 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 hipbones. All of the deficiencies mentioned above may usually 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.
- A condition known as “dumping syndrome” can occur as the result of rapid emptying of stomach contents into the small intestine. This is sometimes triggered when too much sugar or large amounts of food are consumed. While generally not considered to be a serious risk to your health, the results can be extremely unpleasant and can include nausea, weakness, sweating, faintness and, on occasion, diarrhea after eating. Some patients are unable to eat any form of sweets after surgery.
- In some cases, the effectiveness of the procedure may be reduced if the stomach pouch is stretched.
- The bypassed portion of the stomach, duodenum and segments of the small intestine cannot be easily visualized using X-ray or endoscopy if problems such as ulcers, bleeding or malignancy should occur.
- Death can occur despite all the precautions that are taken.
- Surgery has its own set of possible complications. They include: spleen or liver damage (sometimes requiring spleen removal), damage to major blood vessels, lung problems, thrombosis (blood clots), rupture of the wound and perforation of the stomach or esophagus during surgery.
To learn more about your Charlotte North Carolina gastric bypass surgery options, please attend a free weight loss seminar today!