The only change occurring to the stomach that seems to be of clinical significance is a marked decrease in the production of the ghrelin hormone and, consequently, a marked decrease in the feeling of hunger.
Laparoscopic gastric bypass is performed through 5 small incisions instead of one large incision. A camera is placed through one of the incisions and surgical instruments through the others. The operation is performed while watching a video screen. The actual operation on the stomach and intestine is the same for both approaches.
The incision for open gastric bypass surgery is made about 3/4 of the way from the breastbone to the navel. This is about 10-12 cm in some people and up to 40 cm in others.
Numerous studies conducted by experienced laparoscopic bariatric surgeons have shown that laparoscopic gastric bypass is a safe operation. Laparoscopic gastric bypass is technically demanding, and studies show that the degree of experience of a surgeon contributes to its safety.
With laparoscopic gastric bypass, the patient has a shorter hospital stay, less post-operative pain, less scars and can return to normal activities quicker. Complications such as wound infections and wound hernias are almost completely eliminated with the laparoscopic technique. The risk of serious complications such as leakage is similar with laparoscopic and open gastric bypass.
Laparoscopic gastric bypass is a difficult operation to learn and to perform safely. It also takes longer and is more expensive. For most patients, laparoscopic surgery is preferable (less pain, shorter hospital stay, less scars, faster return to normal activities). As surgeons learn how to perform laparoscopic gastric bypass safely and as patients request it, more and more laparoscopic gastric bypass procedures will be performed.
Yes, but this would require another procedure.
Nutritional deficiencies after gastric bypass surgery are more common than after gastric banding or sleeve gastrectomy. In particular, vitamins A, D, E, calcium, iron, vitamin B12 and folic acid may be deficient. It is important to maintain these multivitamin supplements as prescribed at the clinic. This additional intake is prescribed to prevent nutritional deficiencies.
A follow-up is essential for the success of any bariatric procedure. The gastric bypass patient should have a follow-up 6 weeks after the operation and 3 months afterwards. Thereafter, the patient should be reviewed at least once a year. Blood tests to assess your nutritional status will be an integral part of your follow-up.
Laparoscopic gastric bypass surgery does not limit physical activity. Aerobic exercise, endurance training and any type of sport can be safely performed for a few weeks after the procedure.
Weight loss is achieved through an early feeling of fullness created by the small gastric pouch. Patients become intolerant to sweets due to the rapid intake of sugar in the small intestine, which leads to unpleasant symptoms called “dumping”. Sweets and “fatty” foods should therefore be avoided. The suppression of appetite by gastric bypass is even more important, because the rapid entry of food into the small intestine creates a hormonal effect that induces fullness and satiety. This hormonal effect is also believed to be responsible for the 75% recovery rate from type 2 diabetes.
Weight loss with gastric bypass is significant and long-lasting. On average, weight loss after 12 months is between 60 and 70% of the excess weight. About 50% of the weight loss is maintained after 10 years.
This is not always necessary, as the skin is often elastic, and the excess skin is not visible. In more specific cases, about 30% of cases, the patient will need further plastic surgery to remove the imperfections caused by the weight loss. Cosmetic surgery is generally not recommended until the weight loss has stabilised, which is usually 2-3 years after the operation.
Post-operative pain is very low thanks to laparoscopic surgery. The surgeons strive to make you recover quickly by limiting complications and reducing the hospital stay, which is usually no more than 3-4 days. There are various bandages available to help control any post-operative pain you may experience.
Most patients will be hospitalized for 3-4 nights. Also, most patients will take about a week to return to work. If the patient has a more physical job, we suggest about 2 weeks before returning to regular work.