Surgery Options

 

Gastric Bypass

Roux-en-Y Gastric Bypass

 

During this surgery, the surgeon creates a pouch similar in size to an egg therefore restricting the volume that can be eaten.

However, this pouch is detached from the main part of the stomach. The lower part of the small bowel is then cut, moved up to and attached to the pouch.

The bowel that has been bypassed is then attached to the small bowel, thereby allowing the digestive juices from the pancreas to be mixed with the food coming from the small pouch.

 

One Anastamosis Gastric Bypass

 

One- anastomosis simply means one join. During this surgery, the surgeon creates a pouch restricting the volume that can be eaten.

This pouch is detached from the main part of the stomach. The lower part of the small bowel is then bought up to connect to the new stomach in a loop (it is not cut).

Food now bypasses part of the small bowel thereby allowing food and the digestive juices from the pancreas to be mixed at a lower point in the bowel.

 

The bypass works in two ways

It restricts the amount that can be eaten and the by-passing of some of the small bowel means that there is a reduction in the amount of calories, protein, vitamins and minerals absorbed.

To try to prevent vitamin and mineral deficiencies, you will be required to take a daily vitamin and mineral supplement for life.

You will be expected to have regular blood tests to ensure nutritional adequacy, which may require further supplements such as iron, calcium, Vitamin D, Zinc etc.

 

What are the Benefits and Drawbacks of having a Bypass?

Benefits:

  • You can expect to lose 60 – 70% of your excess body weight after 2 years
  • Average initial weight loss is quick
  • Evidence suggests that gut hormones can be altered which affects appetite
  • Has a high-resolution rate of diabetes (75%)

 

Drawbacks:

  • Has a higher mortality rate (1;250 chance) and more serious complications than other operations
  • It will be necessary to take multivitamin and minerals for life. You may need to take extra supplements based on your dietary intake and blood tests
  • ‘Dumping syndrome’ can occur after eating foods with too much sugar or fat, with symptoms including; nausea, sweating, faintness, vomiting and potentially diarrhoea
  • It is effectively irreversible. For example, if it were deemed an medical emergency, it could be reversed
  • Medication needs to be reviewed to ensure adequate absorption
  • You may not lose or maintain weight loss if you do not stick to healthy eating and lifestyle guidelines
  • It is recommended you avoid alcohol for 1 year after surgery. It may be limited after this, as the side effects of alcohol can occur more rapidly after the bypass

Please note: Lifelong vitamin and mineral supplements are expected with both the Gastric Bypass and the Sleeve Gastrectomy and you will need regular bloods tests to monitor your nutritional status

 

Which bypass will be right for me?

The surgeons will discuss which operation would be suitable for you at your one-stop appointment. Certain medical conditons such as reflux or a hiatus hernia will mean that a one anastomosis gastric bypass would not be suitable.

 

 

Sleeve Gastrectomy

Originally, this surgery was suggested to patients as a ‘halfway’ house, in order to reduce weight and surgical risks.

This was then converted to a full bypass once the patient had lost a significant amount of weight.

Due to its success, this surgery is now available as a ‘stand alone’ treatment or as an operation prior to a full bypass.

During this surgery, the surgeon removes ¾ of your stomach, leaving a small narrow tube.

It works by reducing your stomach size and therefore restricting the amount of food that can be eaten.

It can also affect the hormones which regulate your appetite, making you feel less hungry.

 

Benefits

  • You can expect to lose 50 – 60% of your excess body weight after 2 years
  • It can be converted to a full bypass if needed
  • Evidence suggests that gut hormones can be altered which affects appetite
  • Compared to the bypass, less likely to suffer nutritional deficiencies unless the diet is unbalanced. However, with such a relatively new procedure, please note this may change as new evidence is collected

 

Drawbacks

  • It is a relatively new procedure as a ‘stand alone’ treatment, so long term data is not yet available
  • It is non-reversible as 75% of the stomach is removed from your body
  • You may not lose or maintain weight loss if you do not stick to healthy eating and lifestyle guidelines
  • Its effects on appetite may only be temporary
  • It is recommended you avoid alcohol for the 1st year after surgery. Alcohol intake may still be limited after this

 

Please note: Lifelong vitamin and mineral supplements are expected with both the Gastric Bypass and the Sleeve Gastrectomy and you will need regular bloods tests to monitor your nutritional status.