Gastric Bypass Surgery (Roux-en-Y) ...
Gastric bypass surgery works in two ways, the stomach
is reduced in size and a part of the intestine is bypassed.
You feel full more quickly than when your stomach was its
original size, which reduces the amount of food you eat
and thus the calories consumed. Bypassing part of the intestine
also results in fewer calories being absorbed. This leads
to weight loss. Gastric Bypass Surgery is known as the "Rolls
Royce" of bariatric procedures, this is because it
is relatively trouble free there is little requirement for
aftercare. Eating is easier than with other bariatric procedures
and the candidate has a far more normal diet and lifestyle,
even the occasional glass of bear is possible.
This is of course major surgery and like all major surgeries
things can go wrong but the health risks associated with
obesity far exceed any risks associated with this surgery.
For such candidates with a BMI of over 60 where surgery
carries a larger risk the gastric
balloon can be used to promote short term weight loss
and reduce the candidates BMI to an operable level.
Average weight loss with the Gastric Bypass is approximately
70% of the excess weight over 2 years. Once the ideal weight
has been reached it remains stable. This is the most effective
procedure for candidates with a high BMI.
The procedure can be either open or Laprascopic.
What
is Laprascopic surgery?
Laparoscopic surgery is performed through
a small tube. Many people are of the opinion that there
is only one incision. This is not the case. Laparoscopic
surgery has normally three incisions. The smallest incision
(about 2cm) is located in the navel so as to disguise any
post operative scarring, through this opening a tube is
inserted that inflates the stomach cavity like a balloon.
This enables the surgeon room to see clearly and be able
to carry out the procedure with ease and safety. Two incisions
2 - 3 cm long and located on either side of the tummy (depending
on the procedure). One is for the camera lens which places
the whole view of the procedure up on a wide screen TV in
front of the surgeon. The second is for the instruments
which are used to carry out the procedure. The advantages
of a laprascopic procedure are the fast recovery, rapid
healing process, and also the lack of scars afterwards.
How
does the Gastric Bypass work?
With gastric bypass surgery procedure as with the Mac Lean
vertical banded gastroplasty the stomach is apportioned
and a smaller pouch is created. In addition to this procedure
a part of the intestine is bypassed reducing the level of
food absorption. This means that the candidate has both
a smaller stomach and a partial intestinal bypass. The candidate
is hit with the “double whammy” of feeling full
sooner and absorbing less of their food.
The excluded and unused portion of stomach remains healthy
and unchanged making the procedure reversible.
Advantages
With the Roux-en-Y Gastric
Bypass, people eat much more normally with little likelihood
of vomiting. The quality of life is excellent and there
is a good chance of reaching and staying at your ideal weight.
Aftercare requirements are relatively simple a blood test
is required 6 months after surgery, this is to monitor the
blood and ensure that the suture has no leaks, in addition
it is a check to ensure that the candidate is receiving
a sufficient vitamin intake. The candidate will find that
their weight will drop evenly and relatively rapidly for
the next two years. Candidates often wish to have cosmetic
surgery following on the success of their their weight loss
surgery. Tummy tucks (abdominiplasty) and some skin tightening
even breast lifts can greatly enhance the way a person feels
about themselves and markedly change their appearance. However
before considering cosmetic surgery make sure that your
weight has been stable for 6 months.
Disadvantages
As with all major surgeries
there are risks associated with gastric bypass surgery.
Many patients are concerned that the risks of apportioning
the stomach can lead to major complications. Rarely does
this happen. In a very few cases the stomach has leaked
and this can usually be corrected. Very rarely it has led
to death but only in a very few candidates and usually due
to other failings of the surgeon or health management where
the surgery took place. A competent well practiced surgeon
will not have any failures in this area. To measure their
effectiveness check how many procedures the surgeon has
carried out.
Once the stomach has healed the internal joins completely
heal up the staples heal over and the stomach wall is as
it was before it was cut. The part of the stomach that is
no longer used remains quite healthy but unused. This means
that at any time it can be reconnected and the procedure
reversed.
The candidate will absorb less vitamins and food and as
such may need to take vitamin supplements on a daily basis.
In addition medicines and drugs may be less absorbed. Candidates
that loose excessive amounts of weight become more fertile.
If they are on "the pill" then the hormones that
are the active ingredient of "the pill" will not
be absorbed as effectively so pregnancy can occur.
The candidate will have to replace their clothes so careful
planning can save money in this area. Many candidates have
found that they need some form of cosmetic surgery to reduce
the amount of excess skin and generally tighten and remove
loose areas. This should be planned for 2 years after surgery.
Laparoscopic
Gastric Bypass or Mclean Gastroplasty
Instructions For When The Patient Arrives Home
On the instructions
of Dr Bruno Dillemans and when the patient arrives
home the following instructions
should be followed:
- is able to
move about normally, the white anti-flebitis stockings
must to be worn.
- Prescription:
o Subcutaneous
LMWH (Clexane 40 mg or Fraxiparine 0.4) for another
10 days
o Zantac 150 mg,
1x/day for 28 days
- Please be sure
to follow strictly any dietary advice or instructions
given by the dietician at the hospital.
- The use of aspirin
or non-steroidal inflammatory drugs are prohibited
as they can cause stomach ulcers.
- The use of aspirin
or non-steroidal inflammatory drugs (such as Ibuprofen,
Nurofen) are prohibited as they can
cause stomach ulcers.
- In case of pain
paracetamol or paracetamol with codeine may be taken.
Dr. Bruno Dillemans
AZ Sint-Jan Hospital
Bruges
Belgium
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Gastric Bypass Program - Open & Laparoscopic Surgery
- We contact you to
set a target date for treatment and confirm your travel
details
- We send you a confirmation
& invoice
|
Day 1
