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Gastric Bypass
Gastric Bypass


Gastric bypass Gastric bypass is the surgical creation of a small pouch in the stomach to restrict food intake to far less than could be eaten before. A typical bypass patient, for instance, will only be able to hold a cup of food or less at a single meal. Weight is lost because far fewer calories are consumed and because a large section of the small intestine is bypassed which causes a decreased ability to absorb nutrients in food.

Benefits of Gastric Bypass

The benefits of gastric bypass include having a more normal life by losing massive amounts of weight – often over 100 to 200 pounds. Patients look better, fit into more normally sized clothes, are able to return to a more active lifestyle and drastically lower the risk factors associated with the major illnesses and conditions associated with morbid obesity. Yearly, 300,000 people in the U.S. die prematurely because of complications from massive obesity. Obesity is a cause of death second only to premature deaths related to cigarette smoking. In the year 2000, (the last year for which census statistics are available) costs related to obesity and overweight amounted to $117 billion. Obesity has been recognized as a chronic disease since 1985. About one-third of American adults are obese.
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Who would best represent an Ideal Candidate for Gastric Bypass?

"Obesity is established as

as a major risk factor for diabetes, hypertension, cardiovascular disease and some cancers."

The ideal patient is at least one hundred pounds overweight, has tried – and failed – at least six diets, is between 15 and 65 years old, understands all the risks of the bypass procedure and is psychologically suited and able to actively take part in the many aspects of the post-operative, follow-up program for life. The most common way physicians screen candidates is by figuring their Body Mass Index, or BMI, a number that shows body weight adjusted for height. Candidates for gastric bypass must have a BMI of 40. Some patients who are suffering related conditions like life-threatening cardiopulmonary ailments or severe diabetes mellitus can have a BMI of 35 or more. (A B.M.I. calculator is found
here.) Obesity is established as a major risk factor for diabetes, hypertension, cardiovascular disease and some cancers. Other associated conditions include sleep apneas, osteoarthritis, stroke infertility, intracranial hypertension, gastro-esophageal reflux and urinary stress incontinence.

Because there are so many complications, and because the surgery itself carries many risks, candidates must go through extensive psychological counseling and screening before going through with the operation.
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Where do I begin?

To find out which procedure works best for you, consult a qualified practitioner who has extensive experience in performing gastric bypass. Sometimes, finding qualified doctors is not easy. So CosmeticSurgery.com has created an easy and effective way for patients to find a cosmetic surgeon online. For more information, please
CLICK HERE.

During consultations, doctors can learn more about the patients and vice versa. This visit gives the doctor a chance to evaluate the current state of the patient’s body and discuss options that will help the patient achieve a desired look. Consultation visits also give patients the opportunity to talk about their goals and expectations for their treatment and to ask any questions they might have. These visits also allow the doctors to inform the patient of the benefits, precautions, treatment response, adverse reactions, methods for administration and other important information.
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What are the Different Types of Gastric Bypass Procedures?

Currently, there are two main types of gastric bypass procedures: The Roux-en-Y and the Extensive Gastric Bypass.

* Roux-en-Y: The most common gastric bypass procedure currently performed. It creates a small stomach pouch to hold food by stapling most of the stomach and causes much of a meal to bypass that area of the intestines where many nutrients are absorbed. In some cases, a restrictive band is added to the bottom of the pouch. The band slows emptying of the pouch and is known as Vertical Banded Gastroplasty.

* Extensive gastric bypass (bilopancreatic diversion.): A more complicated operation, this procedure surgically removes portions of the stomach and attaches it directly to the small intestine.
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How are Gastric Bypasses Performed?

Depending on the size of the patient, the Roux-en-Y can be performed through a very small incision with laparoscopic techniques or through a larger incision, in an operation known as open surgery. The stomach pouch is created by stapling or banding part of the stomach together. That limits how much food the patient can hold. Then, a Y-shaped section of the small intestine is attached to the pouch to allow yet more food to bypass that section of the intestines where many nutrients, and calories, are absorbed.

The extensive gastric bypass, a large part of the stomach is surgically removed to create a small food pouch. This operation promotes rapid weight loss but is not widely used because it creates a high risk of nutritional deficiencies and additional problems for the patient.
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How Much Pain is Associated with Gastric Bypass?

Patients can expect major swelling, bruising, some pain and post-operative hospitalization. Usually, your doctor gives you prescription medications to control any discomfort. The procedure is usually performed in a hospital operating room.
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What are The Long-Term Effects of Gastric Bypass?

People who have gastric bypass operations usually lose two-thirds of their excess weight within two years after the operation. The food pouch initially holds about one ounce of food and expands to two to three ounces over time. The small outlet delays the emptying of food from the pouch and causes a feeling of fullness so the patient eats less.

Because many nutrients are not absorbed by the body after gastric bypass, anemia can be a long-term effect. That, in turn, can lead of osteoporosis and metabolic bone disease. Thus, gastric bypass patients must take nutritional supplements that usually prevent such deficiencies. Many patients require not only close monitoring but the life-long use of special foods and medications. After gastric bypass surgery, your body will not easily tolerate meals that are high in sugars and fats, foods that may make you physically uncomfortable and are usually avoided. All those changes allow people highly prone to overweight to lose weight and keep it off for the long term. Moreover, recent studies have shown that gastric bypass result in altering the release of hunger-causing hormones so that the patient’s appetite is reduced.

Once their weight has been stabilized at normal levels for at yeast a year, gastric bypass patients usually need yet another operation known as
body shaping to remove large amounts of excess skin which has been extremely stretched by the massive overweight.
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What Are the Risks and Limitations of Gastric Bypass?

The operation has about a 1% death rate and is higher than those of other primary operations. Immediately following surgery, possible risks include incision infections, the wound bursting open (dehiscence,) leaks from staple breakdown, marginal ulcers, various pulmonary problems and deep clotting in veins (thrombophlebitis.) About ten percent of patients suffer some post-op complications.

Moreover, the way a patient eats will be forever changed; many patients must eat eight to ten small meals a day to obtain enough nutrients and can drink nothing while eating because the pouch can’t hold both liquid and food. Because the pouch can hold so little food, patients are routinely told to eat protein first because that is the most necessary nutrient.

Additional risks include:
  • Pouch stretching. Over time, and because of eating too much, the stomach gets bigger and stretches back to its normal, pre-surgery size.
  • Band erosion. The band that closes off part of the stomach disintegrates.
  • Breakdown of staple lines. The band or staples fall apart and return the stomach to its pre-operative size.
  • Leakage. Stomach contents can leak through the stitches. That’s dangerous because the acid can eat away at other organs.
  • ”Dumping” Syndrome. Stomach contents can move too rapidly through the small intestines. Problems caused can include nausea, weakness, sweating, flatulence and, occasionally, diarrhea after eating, as well as the inability to eat sweets without becoming extremely weak.
  • Nutritional deficiencies. Some patients just can’t eat enough to prevent health problems.

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What Are the Typical Costs Associated With Gastric bypass?

Because the operation involves substantial time of highly trained surgeons, anesthesiologists, psychologists and other medical subspecialties, plus a great deal of hospital time and numerous follow up visits, gastric bypass can range between $20,000 and $55,000.
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Ten Questions Gastric Bypass Patients Should Ask Their Surgeon

Prior to all procedures, a consultation should occur between the prospective patient and the providing surgeon. During this consultation, the surgeon and patient will discuss the treatment plan like the desired outcome, various options that are available to achieve it, the procedure itself as well as various risks and limitations. The surgeon will also provide information regarding anesthesia options, the location and description of where the procedure will be performed (i.e., hospital vs. office surgical suite) and associated costs. A discussion regarding the patient’s medical history and reasons for wanting the surgery, will also take place during the consultation.

To learn more about gastric bypass and have realistic expectations, the patient about, it is recommended that the patient look at before and after photographs, speak with previous bypass patients, (you are always welcome to ask your doctor for referrals to previous patients and where to contact them) and get answers to the following questions:
  1. Are the desired results I described realistic?
  2. Where is the bypass performed and how long will it take?
  3. In my case, what technique and which bypass is most appropriate?
  4. What kind of anesthesia will the surgeon use during the surgery?
  5. How much does bypass cost and what other elements factor into that cost (i.e., hospital fee, anesthesia, etc)?
  6. What is the surgeon’s level of experience in performing gastric bypass?
  7. What percentage of patients experience complications with the bypass?
  8. What is the surgeon’s policy in regards to correcting or repeating the procedure if the bypass does not meet agreed upon goals?
  9. What should I expect, post-operatively, in terms of soreness, scaring, activity level and so on?
  10. Have you ever had your malpractice insurance coverage denied, revoked or suspended?
In addition to the previously mentioned questions, it is important that gastric bypass patients relay to their surgeon information regarding any allergies and serious medical conditions they may have. Furthermore, patients should inform the surgeon of any medications they are taking.

This site provides information about plastic/cosmetic surgery and is designed to help users make decisions regarding their own treatment options. But medical information is not the same as medical advice--the application of medical treatment to a person's specific circumstances. Although we go to great lengths to make sure our information is accurate and useful, we recommend you consult a qualified medical practitioner if you want professional assurance that our information, and your interpretation of it, is appropriate to your particular situation.
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