After laparoscopic gastric bypass surgery, your small upper stomach will hold about one-fourth cup of food. After eating just a nibble or two, you will feel full, and your appetite will be reduced. This causes weight loss. Although the food you eat is digested, your body cannot get all the nutrients you need. You need vitamin and mineral supplements to help your surgical wound heal and avoid health problems such as anemia, nerve problems, osteoporosis and others.
On an average, patients will lose 120 pounds or about 70% of their excess weight in one year. Some people lose a little more, some a little less. Weight loss will continue during the second year at a less rapid rate.
About 5 percent of patients will not lose as much weight as they would like, but will still lose weight. Think of gastric bypass as a tool to help you lose weight and eat healthier foods. Most patients say it is the first time they have stayed on a successful diet that makes them feel good.
In 1991 the National Institutes of Health (NIH) assembled physicians, nutritionists and other health care professionals and made recommendations regarding bariatric treatment. "Bariatric" means obesity. From this gathering, the NIH now recommends that weight reduction should always be recommended for patients with severe obesity. If nutrition therapy, exercise, and behavior modification cannot successfully reduce weight, bariatric surgical procedures such as the Roux-en-Y gastric bypass, vertical gastric sleeve and adjustable gastric banding are options. For many years these procedures required an incision from the breast to the groin, the open method, which comes with certain risks.
Since then, the laparoscopic method, which requires several one-inch incisions in the abdomen, has been approved as an alternative method to perform these surgical procedures. The Roux-en-Y gastric bypass, gastric sleeve and adjustable gastric banding are available at the Vanderbilt Bariatric Surgery Center and can be performed as either open or laparoscopic procedures.
It is important for anyone considering bariatric surgery to understand the many medical, psychological, behavioral and financial aspects. For your recovery to be successful, you will need to make some lifelong changes. Some of the changes may seem difficult, but the result can be permanent weight reduction and overall improved health.
Risks and Complications of Gastric Bypass Surgery
All types of gastric bypass surgery are major operations. They are performed only to reduce major risks to your health from obesity and are not cosmetic surgery. You should understand your risk, which will depend upon your degree of obesity and conditions such as diabetes, heart and/or lung disease.
Obesity can make surgery and anesthesia more complicated and risky. Possible complications during gastric bypass surgery include respiratory problems, infection, cardiac complications, leaks where intestine and stomach are sutured together, and blood clots in the deep veins of the legs. Rarely, death can result from heart attack or a blood clot to the lung, resulting from the body’s response to surgery.
Respiratory complications are a potential risk immediately after surgery. If a patient has another condition involving the respiratory tract, a pulmonary evaluation with a lung specialist before surgery may be recommended. During the operation, special forms of anesthesia may be necessary to minimize effect on the lungs. Using an incentive spirometer every 1 to 2 hours after surgery will promote deep breathing and coughing to prevent lung complications. If you are able, you will sit up in a chair several hours after you wake up from surgery, which will also help your lungs.
If there is a leak or rupture where your intestine is joined to your stomach after gastric bypass or vertical sleeve gastrectomy, this may require an immediate return to the operating room to be corrected. On the morning after surgery, you may have an x-ray test called a gastrograffin swallow to make sure there is no leak. If a leak is detected, re-operation is required and additional drains are inserted. You will be given a feeding tube for nutritional formula to be passed into your intestinal tract below the leak, to allow the site to heal. In some cases, the radiologist in x-ray may place a drain to eliminate the need for this surgery.
After surgery, you may be constipated. Remember that you will be eating less, and you will have fewer bowel movements. Many people report having a bowel movement every two to three days. You will get instructions about drinking more fluids, taking a stool softener, doing exercises, and adding fiber to your diet to help prevent constipation.
Blood clotting in the leg veins and clots migrating to the lungs are a possibility and could be serious. The larger a person is, the more likely it will happen. Low dose injections of heparin, a blood thinner, are used to prevent clots from forming during times of maximum risk. Also, inflatable boots, elastic stockings and frequent walking after surgery help to decrease the risk of blood clots.
Bleeding during or after the surgery is a complication. Doctors pay close attention to controlling bleeding throughout the operation, with special efforts paid to the spleen and other places where bleeding is more common. If bleeding occurs, blood transfusion, re-operation, and potentially removal of the spleen may be required.
Other potential complications may occur months or even years following surgery. Bowel obstruction can result from adhesions or from internal hernias which may require operative intervention. Vitamin deficiencies can occur particularly if you do not take the prescribed vitamins.
The adjustable gastric band can slip years after surgery which may require surgery to replace it in proper position. The tubing or the port can get infected which may require removal of the port and the band. The band can in rare occasions erode into the stomach which can cause bleeding and infection.