Written by Dr. Alapati
Laparoscopic Gastric Bypass Procedure
The laparoscopic gastric bypass is done by using a laparoscope, which is attached to a video camera, passing through small incisions on the abdomen, providing us with a magnified appearance of the internal organs seen on a TV monitor. The whole surgery is done inside the abdomen after a gas has been introduced to inflate it. Special stapling surgical instruments are utilized to make a new and smaller stomach pouch. The rest of the stomach is taken away, however, is fully stapled shut and separated from the new and smaller stomach pouch. The outlet coming from the small pouch is attached to the small intestine in order that food goes directly into the lower section of the small intestine bypassing the stomach. This is performed by separating the small intestine simply farther than the ligament of Treitz for the goal of taking it up and making an attachment with the new and smaller pouch. The other end is attached to side of the rest of the small intestine forming the Y shape. The effect is an early feeling of satisfaction, mixed with a feeling of fullness that lessens the craving to eat. The laparoscopic way is similar to the open surgery. What is distinct to our method is the utilization of hand-sewing for the gastrojejunostomy, as contrary to making use of stapling instruments. This permits the construction of an extremely small stomach pouch.
Laparoscopic Gastric Bypass Benefits
The latest statistics revealed that Gastric Bypass surgery, with the patient’s help and compliance with doctor’s instructions after the surgery, will let a patient to lose 70 to 80% of his or her extra weight and maintain this weight from regaining in the future. In some cases, patients lose all their extra weight, whereas others who do not comply with the post-operative instructions will lose less weight.
Additionally, if you are suffering from any of these medical conditions, they will improve or cured following the surgery:
- Elevated Blood Pressure
- Asthma
- Diabetes
- Urinary stress incontinence
- Sleep apnea
- Dyslipidemia
- Skin fold dermatitis
- Low back pain
- Gastroesophageal reflux
- Vertebral disk disease
- Weight-bearing osteoarthritis of the hips, knees, ankles and feet
Lastly, the health advantages gained with gastric bypass can lessen your risk of death in so as far as 89% rather than to staying morbidly obese.
Laparoscopic Gastric Bypass Risks
However, these advantages do not come without dangers. The worst thing that could happen is death caused by the operation. The mortality risk will be based on the Body Mass Index, the gender, the associated co-existing conditions and the skill of the bariatric surgeon and the bariatric team.
General Risks:
- Since the duodenum is bypassed, lack of absorption of iron and calcium can happen. Iron deficiency anemia can be possible. This is a concern for patients who have chronic blood loss such as severe menstrual period or bleeding caused by hemorrhoids. Menopausal women, already at high risk for osteoporosis should be cautious of the possibility of increased bone calcium loss.
- Bypassing the duodenum has brought about metabolic bone condition in several patients, leading to bone pain, loss of height, fractures of the ribs and hip bones, and humped back. All of the above-mentioned conditions, however, can be treated by right diet and vitamin supplements.
- A chronic anemia brought about by Vitamin B12 deficiency may happen. The problem can normally be treated with Vitamin B12 tablets or injections.
- A problem called dumping syndrome can happen brought about by fast emptying of the stomach contents toward the intestine. This is at times stimulated when excessive amount of sugar or too much food is taken. Whereas, usually not regarded to be a severe danger to your health, the effects can be very bad and can involve nausea, faintness, weakness, sweating and at times diarrhea after eating. In some patients they cannot eat any kind of sweets after surgery.
- In some instances, the success of the surgery may be lessened if the pouch is stretched or is initially left larger than 30cc after the surgery by mistake.
- The bypassed area of the stomach, duodenum and parts of the small intestine cannot be simply seen using X-ray or endoscopy if concerns like ulcers, cancer or bleeding should happen.
Laparoscopic Gastric Bypass Contraindications
The following are the contraindications of laparoscopic gastric bypass:
- Too old
- Severe immobility
- Endocrine conditions like Prader Willi Syndrome and Cushing’s Syndrome
- Pulmonary disease that needs oxygen therapy
- History of pulmonary embolism
- Mental instability
- Abuse of drug or alcohol
- Refusal to be examined by psychologist or psychiatrist
- Inability to adjust with the diet modifications and lifestyle modifications following surgery
Complicated medical problems increase the risk of operation and are measures on a patient by patient basis.