Gastric bypass surgery: risks, benefits, and different types

In this article below, Mr Ahmed Hamouda, a distinguished upper GI and bariatric surgeon, outlines the various benefits and risks when it comes to undergoing a gastric bypass operation, whilst also explaining the different types of gastric bypass surgical procedures.

What are the potential benefits and risks associated with gastric bypass surgery?

The main benefit associated with gastric bypass surgery is effective weight loss in the long-term (approximately 80 per cent of the excess weight carried by the individual). The risks include bleeding, infection, and clots in leg veins that spread to the lungs. Procedure-specific risks include dumping syndrome, nutritional deficiency, and internal bowel leakage.

How do you determine if a patient is a suitable candidate for gastric bypass surgery?

Suitable candidates for bypass surgery will have a BMI of 40 or above. They usually want long- term, effective weight loss and are willing to contemplate a permanent surgical weight loss procedure. A bypass is particularly helpful for people who have a sweet tooth as dumping stops this habit. It also helps patients who have heartburn and acid reflux problems as it excludes most of the stomach acid from reaching the gullet.

Can you explain the different types of gastric bypass procedures available, and how do they differ from each other?

Gastric bypass surgery can be divided into two operations: a formal Roux-en Y bypass and a mini bypass. The operations entail shortening the bowel by creating segments of bowel that do not participate in absorption, either fully or partially.

This is usually combined with a decrease in the volume of the stomach. A mini bypass has a loop of bowel attached to a small-volume stomach, and there is no loss of small bowel continuity. In a formal bypass, the small bowel is cut, and a long segment is brought up and joined to the small stomach. This has the added benefit of diverting all bile into the lower part of the bowels and away from the stomach pouch.

What lifestyle changes and dietary modifications are necessary before and after the surgery?

Any bariatric procedure involves a lifelong commitment to a change in eating behaviours and activity levels or else they simply do not work in the long term. With bypass, the amount of food that is eaten will be significantly restricted due to the small stomach that the patient will have after surgery.

Eating will need to be slower, and food must be chewed well. Initially, for the first few weeks after surgery, only liquids are allowed, followed by a soft-food diet, gradually building up to solids over a period of time. Generally, individuals do not feel as hungry as they used to prior to surgery.

What is the typical recovery timeline after gastric bypass surgery, and when can patients expect to see significant weight loss results?

The first day after surgery, patients are walking the hospital corridor with minimal discomfort. There are no tubes or drains to deal with and oral-free fluids are given. Following one or two nights in hospital, patients can get home and enjoy slow leisurely walks for the first few weeks. It is not advised to drive for a couple of weeks, and it is best to avoid any strenuous activity such as lifting heavy objects for five to six weeks.

If you are considering whether or not gastric bypass, make sure you consult first with Mr Ahmed Hamouda. You can do just that via his Top Doctors profile.