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The Gastric Bypass is considered by the American Society for Metabolic & Bariatric Surgery (ASMBS) and the National Institutes of Health (NIH) as the golden standard of weight loss surgery, and is recommended as the most successful procedure for losing overweight and controlling it over time. It is the most widely performed bariatric surgery in the entire world.

The Gastric Bypass is a mixed surgical technique, which benefits from gastric restriction by sectioning the stomach along the minor curvature, which makes the patient feel satisfied after a smaller amount of food and, at the same time, benefits from poor intestinal absorption by associating a derivation of the food so that it does not go through the first intestinal handles. This results in reduced absorption of nutrients and calories. Thus, the mechanisms for slimming are more effective and sustained over time, keeping patients in a state as close as possible to their normal weight.

Some of its principal advantages are that Gastric Bypass Surgery produces a fast initial weight loss, it can be performed using a minimally invasive procedure and has a greater average total weight loss than other techniques do. It can cause some medical complications due to nutritional deficiencies if a suitable follow-up is not implemented and it has a higher rate of surgical complications than the Gastric Sleeve or Adjustable Gastric Band surgeries.

 
 
The Gastric Bypass Surgery can be performed by open surgery or by laparoscopy; nevertheless, laparoscopy offers all the benefits of minimally invasive surgery, that is to say, less pain and a rapid recovery. In addition, the great advantage of laparoscopy for obesity is the drastically reduced rates of incisional hernia (up to 20% in open surgery) and a low rate of infection in the operative wound (up to 17% in open surgery).

Dr. Dick Manrique is a bariatric surgeon from Lima Obesity Surgery Center. There he performs Gastric Bypass Surgery by laparoscopy, with a three-days hospital stay.

 
 
» What will my diet be like after Gastric Bypass Surgery?
» Will I need to take any vitamin complements then of Gastric Bypass Surgery?
» What complications does the Gastric Bypass Surgery have?
» What complications does the surgery have?
» How long will I need to stay in hospital?
» Will my medical problems improve after the Gastric Bypass Surgery?
» What is the Gastric Bypass Surgery’s success rate?
» Is it possible to perform other surgeries associated to the Gastric Bypass by laparoscopy?
» Will I require plastic surgery for the excess skin once I have lost an significant proportion of my weight?
» Can I get pregnant after a Gastric Bypass Surgery?
 
 
 
What will my diet be like after Gastric Bypass Surgery?

During the first month after the Gastric Bypass Surgery, you are advised to go on a diet based mainly on mashes, compotes, soups, broths and any type of liquid. In general, you can eat “anything,” as long as it is crushed or mashed. This is to prevent problems with the recently constructed gastric yeyune anastomosis and with any possible edema or initial inflammation. It also avoids possible initial vomiting or intolerance to some types of food.

One, or one and a half months after the operation, an x-ray check is run to ensure the correct transit from the gastric reservoir to the intestine. From this moment on, solid food starts to be added, little by little, adding vegetables, fruit, fish and, lastly, beef.

Normally, three months after the Gastric Bypass Surgery, you will be eating practically anything, with very rare vomiting or nausea. Even though any type of food is generally allowed, the amounts are usually small, since there is soon a sensation of satiety after small amounts.

 
 
 
Will I need to take any vitamin complements then of Gastric Bypass Surgery?

After a Gastric Bypass Surgery, some nutritional deficiencies may appear due to the reduced absorption of vitamins, such as A, D and K, folic acid and vitamin B 12, as well as calcium and iron. In general, this can be prevented by taking the necessary vitamins and nutritional supplements after the surgery. They must be taken permanently.

 
 
 
What is the Dumping Syndrome?

It is a physiological reaction observed in some patients who have undergone a Gastric Bypass. This syndrome is characterized by a very unpleasant body reaction that includes sensations of dizziness, throbs, profuse perspiration, nausea and sometimes abdominal pain or diarrhea after having drinks and/or food with a high content of glucose. These symptoms can be avoided by keeping off foods with high sugar content.

 
 
 
What complications does the Gastric Bypass Surgery have?

Although the Gastric Bypass operation is considered to be safe, the complications that arise from this procedure are similar to those of any other abdominal surgery. Given the similarity to open surgery, the Laparoscopic Gastric Bypass procedure shows an almost identical spectrum of complications to that of open surgery, such as pipes, intestinal obstruction, as well as the risk of pulmonary embolism and deep venous thrombosis. Nevertheless, there are several postoperatory complications that seem to be more frequent in laparoscopic procedures, such as gastric yeyune stenosis and internal hernias. There are other complications that are more usual in open surgery such as infection and dehiscence of the operatory wound and incisional hernia. The rate of major complications is approximately 10 %.

 
 
 
How long will I need to stay in hospital?

Patients are generally hospitalized on the day before the surgery and most of them remain in hospital for an average of 3 to 4 days.

 
 
 
Will my medical problems improve after the Gastric Bypass Surgery?

After the Gastric Bypass Surgery, some diseases associated to obesity (co-morbidities) have been known to improve or even heal. High blood pressure is cured in 75% of the cases and improved in 90% of them. Diabetes mellitus is cured in 83% and improved in 100% of them. Cholesterol and triglycerides alterations are cured in 65% of the cases and improved in 93% of them. There are also other significant improvements in asthma, osteoarthritis, sleep apnea and other co-morbidities.

 
 
 
What is the Gastric Bypass Surgery’s success rate?

The Gastric Bypass is the most effective procedure. An average of 77 percent of excess body weight loss has been noted one year after surgery. Studies have shown that after 10 to 14 years, patients have maintained 60 percent of excess body weight loss.

 
 
 
Is it possible to perform other surgeries associated to the Gastric Bypass by laparoscopy?

Yes, indeed. The great advantage of the laparoscopic approach is that we can associate surgeries that sometimes need to be performed during the same surgical intervention, taking advantage of the minimally invasive surgery. Among these procedures is cholecystectomy, that is to say, the removal of the gall bladder due to gallstones or any other associated pathology, which are very common in obese patients. The repair of hernias, which commonly arise with obesity, hepatic biopsies, an inevitable procedure in obese patients due to the high degree of hepatic steatosis associated. Other surgeries to consider are gynecological, adhesiolisis or liberation of adherences, repair of hiatal hernias, and so on.

 
 
 
Will I require plastic surgery for the excess skin once I have lost an significant proportion of my weight?

This is not always the case. As a general rule, plastic surgery will not be considered at least for some two years after the operation, as the skin will mold around the new body tissue. Give the skin the time it needs to adjust before deciding to undergo further surgery. Abdominal dermolipectomy or repair of the hanging cutaneous tatter of the abdominal fat is considered only when deemed necessary and the patient demands it.

 
 
 
Can I get pregnant after a Gastric Bypass Surgery?

Morbid obesity produces infertility and many women cannot become pregnant, but if they do, there is a serious risk for the baby’s and mother’s health. Once operated on, the chances of becoming pregnant are much higher than when they were obese, and it is necessary to exercise control during the initial period, as it is inadvisable to become pregnant immediately. The recommendation is to avoid pregnancy during the first year after the operation. After that period, the body situation is ideal for pregnancy, just like for any healthy woman in her fertile period.

 
 

Lima Obesity Surgery Center ®
Jr. Bernini 352, Oficina 206, San Borja, Lima, Perú
Phone: (51-1) 224-6252
info@cirugiadeobesidad.net    www.cirugiadeobesidad.net

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