Types of Gastric Bypass Operations
Roux-en-Y gastric bypass (RGB): is the most common gastric bypass procedure. In this, a part of the stomach is stapled together or vertically banded to form a small pouch. This causes the amount of food that can be eaten to be limited. Then, to allow food to bypass the duodenum as well as the first portion of the jejunum, a Y-shaped section of the small intestine is attached to the pouch. This reduces the calorie and nutrient absorption.
Extensive gastric bypass: Portions of the stomach are removed in this more complicated gastric bypass operation. The small pouch that remains and the final segment of the small intestine are then connected directly, completely bypassing both the duodenum and jejunum. This procedure is not widely used because of the high risk for nutritional deficiencies, even though this procedure successfully promotes weight loss.
Those gastric bypass operations that cause malabsorption lead to greater weight loss than the restriction operations, which only decrease food intake.
Open vs. Laparoscopic Gastric Bypass
Open
Since the 1950s, when it was conceived, surgeons have used open gastric bypass surgery for obesity extensively, documenting its efficacy and safety. The large incision that is required is directly related to many of the major risks of this procedure. The incision is a leading cause of the cardiopulmonary problems, like pneumonia and congestive heart failure and wound problems like infection and hernia.
Laparoscopic
In order to address the problems being faced with the open gastric bypass procedure, laparoscopic gastric bypass was introduced in 1993. There are several advantages of the laparoscopic procedure, for patients, on account of the smaller incisions. These include:
- Lower levels of post-operative pain
- Quicker recovery
- Less of wound related problems like infection, hernia and adhesions
The loss of weight and other health related benefits provided by each approach appear to be quite similar.
However, the laparoscopic procedure is not recommended for all patients. Those who have a body mass index of more than 60 and those, whose body weight exceeds 400 pounds, may not be candidates for laparoscopy. Also, those who have had stomach surgery before may also not be candidates for laparoscopic gastric bypass. However, with a medically supervised weight loss program, some who are not laparoscopic candidates at first can become eligible.
Hence, despite many potential risks, gastric bypass can prove to be quite useful.
|
