There are a few accepted surgical procedures for morbid obesity. One procedure that is presently favored by surgeons is the Roux-en-Y Gastric Bypass (RGB). This is one of the most commonly performed weight loss surgeries worldwide. 75% of individuals seeking surgical weight management choose the RGB method.
According to the American Society for Bariatric Surgery (ASBS) and the United States National Institutes of Health (NIH), the Roux-en-Y gastric bypass is considered the current gold standard in modern weight loss surgery. There are two approaches to gastric bypass weight loss surgery; the open gastric bypass surgery and the laparoscopic gastric bypass surgery. These operations are used to treat the severe accumulation of excess fatty tissue and the health problems it causes. Performed laparoscopically or in open surgery, the gastric bypass operation and its variations are;
- Minimal access gastric bypass - Proximal operative procedure for weight reduction.
- Minimally invasive gastric bypass - Distal operation for overweight management.
- Loop Gastric bypass or mini Gastric bypass for weight loss.
An individual is an ideal candidate for RNY gastric bypass surgery if one is morbidly obese and has obesity related health problems that significantly interfere with employment, physical mobility or family function. An ideal candidate is a person with a Body Mass Index (BMI) above 35 suffering from diabetes or any other obesity related problems such as heart disease, severe sleep apnea, or respiratory insufficiency. Obese men and women who have a mind-set to make long term lifestyle and behavioral changes to manage body weight through diet and exercise are also good candidates for RNY gastric bypass procedure.
The gastric bypass surgery procedure is performed by a bariatric surgeon laparoscopically or as an open surgical procedure. This involves creating a small stomach pouch by bypassing most of the stomach and a varying amount of small intestine. Weight reduction is accomplished both by restriction of food and by malabsorption of nutrients. The expected hospital inpatient stay after laparoscopic gastric bypass procedure is 3 to 4 days. Following open gastric bypass surgery, one can expect a hospital stay of 5 to 6 days.
Post-operative recovery and recuperation time in Thailand involves a stay of 10 to 14 days after laparoscopic gastric bypass surgery and 17 to 21 days following open gastric bypass procedure. Dietary guidance by an obesity dietician should be followed before returning back to a normal diet. Life-long use of special foods and medications such as vitamin supplements are advised. Very light physical activities can be resumed within 7 days and the bariatric patients can usually return back to work within 18 to 21 days.
Advantages and benefits of gastric bypass surgery - The benefits of the gastric bypass procedure heavily outweigh the disadvantages. 75% of patients are expected to lose 70% to 80% of their excess body weight. Hypertensive and type II non-insulin dependent diabetes patients should no longer require medication. Drastically improved post-operative conditions include a reduction in sleep apnea, arthritis, reflux, fatigue, asthma, shortness of breath, and joint pain.
Complications of gastric bypass surgery and medical risks of gastric bypass surgery include; infections in the incision, leaks from the stomach resulting in peritonitis, blood clots, and nutritional deficiency. RNY gastric bypass surgeries may cause 'dumping' syndrome which causes nausea, weakness, sweating, faintness, and possibly diarrhea after eating. These gastric bypass surgery symptoms and side effects can be made worse by eating highly refined, high-calorie foods like sweets.