Weight Loss Surgery

Obesity that poses a health threat is often treated successfully with gastric bypass surgery. This article will improve your understanding of obesity, its causes, and its health risks. Learn about the relevance of your body mass index and how you calculate it.

What You Need to Know about Weight Loss Surgery

This article gives you an introduction to the different types of weight loss surgery, what's involved, related issues, and links to guide you to more information about your options.

Are You a Good Candidate for Weight Loss Surgery?

Bariatric surgery candidates are those who have not been able to lose weight through traditional forms of treatment. If you have been struggling with chronic obesity for many years, you may be a good candidate. However, not everyone who wants to lose weight should undergo bariatric surgery.

Gastric Bypass Surgery

Bariatric surgery, also known as gastric bypass surgery, is a complex weight loss surgery. Currently two techniques are available: the Roux-en-Y-gastric bypass and the biliopancreatic diversion bypass.

The gastric bypass procedure, also known as bariatric surgery or weight loss surgery, is a complex procedure performed under general anesthesia—you sleep through it. Time in surgery is approximately one to four hours, followed by a one- to seven-day stay in the hospital. Currently, there are two techniques available for gastric bypass:

• Roux-en-Y-gastric bypass (traditional and laparoscopic)
• biliopancreatic diversion bypass

(Another form of weight loss surgery that does not involve a bypass is lap banding.)

Roux-en-Y-gastric bypass (traditional and laparoscopic)

The Roux-en-Y bypass is more common and considered less complicated than the biliopancreatic diversion bypass since Roux-en-Y does not remove portions of the stomach.

The traditional Roux-en-Y-gastric bypass is performed through open surgery with one long incision. The Roux-en-Y gastric bypass can also be performed laparoscopically. The laparoscopic Roux-en-Y-gastric bypass uses multiple smaller incisions (instead of one long incision)—a laparoscopic tool is inserted, which offers a visual guide to the inside of the abdomen during the procedure. The laparoscopic Roux-en-Y produces less scarring and lets you recover faster than the traditional Roux-en-Y-gastric bypass. But the laparoscopic approach is still new, so long-term results have not been fully evaluated.

Biliopancreatic Diversion Bypass

The biliopancreatic diversion bypass is performed through open surgery with one long incision, leaving a permanent scar. It is less common and more complicated than the Roux-en-Y-gastric bypass. In the biliopancreatic diversion, portions of the stomach are removed and the bypass is attached to the distal illium. This procedure is not widely used, because there is more risk of nutritional deficiencies.

Both Techniques Use a Bypass

In both techniques, a small stomach pouch is created, to curb food intake, by stapling a portion of the stomach. Then, a Y-shaped part of the small intestine is attached to the stomach pouch so that food can bypass the duodenum, as the bypass extends to the initial portion of the jejunum. The bypasses of the small intestine are formed to decrease the absorption of food nutrients. These techniques significantly restrict food intake and reduce hunger to promote healthy weight loss. The majority of the weight loss is evident within one year and is usually completed by the end of the second year.

Gastric Bypass Recovery and Aftercare

After gastric bypass surgery, many patients spend two to three days in the hospital, or one to two days for the laparoscopic procedure. On average, most people require two to five weeks of recovery before returning to normal activities. For a number of days, the abdomen will be swollen and sore, and the patient often feels discomfort. Your doctor can prescribe medications to help you manage the discomfort.

All the techniques will leave a permanent scar, but scarring is normally covered by clothing.

Aftercare treatments typically include a dietary plan, regular exercise, behavioral-modification therapy, and vitamin supplements. Your plastic surgeon might require the use of a dietician, an exercise program, and possibly a psychologist for an extended period of time to assist you in your recovery.

Lap Banding

Laparoscopic adjustable gastric banding (lap banding) is a minimally invasive weight loss surgery whereby an adjustable band is placed around the stomach to restrict food intake. The FDA-approved device helps patients feel full sooner.

Panniculectomy

Panniculectomy is a procedure to remove excess skin and fat in the abdominal region that generally reaches below the belly button, extending around to the back. This surgery does not tighten muscle, as in abdominoplasty, but may be performed after abdominoplasty.

Body Lift

Whether tightening up after massive weight loss, or addressing the normal effects of aging or childbearing, a body lift ("belt lipectomy" or "lower body lift") is an excellent way to contour the abdomen, thighs, and buttocks.

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