Gastric bypass surgery is just like any other surgical procedure at the beginning. First, the patient must have a physical exam and be evaluated by a doctor. Then the doctor and patient together will discuss the various options for surgery and weight loss goals. Once both have decided to go ahead with gastric bypass surgery, the surgery will be scheduled. Once the patient enters the hospital, he will go through another physical exam and then be sedated. Once in the operating room, he will receive anesthesia and the surgery can begin.
Stapling and Pouch Creation
While the patient knows what will happen after the procedure, many want to know what happens during the procedure. The first step in gastric bypass surgery is the stapling of the stomach. The stomach is stapled and reinforced with stitches that creates a new (smaller) stomach pouch. The new stomach pouch is only about the size of a golf ball, able to hold only 20 cc at one time. It is made small because it will eventually stretch a little bit, but it is also made small because the pouch will still make stomach acid. The goal is to keep this away from the jejunum as much as possible to avoid complications.
Next, the upper jejunum is divided in order to bring it up to connect to the upper stomach pouch. This part is brought up behind the lower stomach pouch and the colon. It is joined to the upper stomach using either a hand sewn technique or a circular stapler.
When the upper jejunum is divided this creates a new route for food. Now the food will enter the esophagus, go down into the upper pouch, and travel down this extension of the upper jejunum straight to the small intestine.
Insertion of the Drainage Tube
The last step in the gastric bypass surgery is to insert a gastrostomy tube in the patient’s body. This is put in place to allow the stomach juices to escape from the stomach if it cannot easily drain into the small intestine. This tube is placed through the left upper abdominal wall and into the lower stomach. The tube is not necessary in all patients, and the doctor will decide whether one is needed at the time of surgery. If the tube causes complications, it can be removed about 3 weeks after surgery at the doctor’s office.
This is an outline of the actual surgical procedure. For gastric bypass patients, the real work begins after the surgery has been complete. This is when the patients will need guidance so that they can follow a strict diet in order to let their bodies heal as well as restrict their calorie intake. Since the stomach as been reduced to a much smaller size, food needs to be eaten in smaller amounts more often. Gastric bypass surgery patients need to make the commitment to working with a nutritionist and their doctor in order to get the results from the surgery that they want.
(Article originally published by RS Banks on Suite101.com)