Bariatric Surgery General Information
Bariatric surgery can be an effective part of a treatment plan for weight loss. Learn more about the general facts of bariatric surgery in the interview below with Dr. Alexander Ramirez, a general surgeon at Tallahassee Memorial HealthCare.
How Gastric Bypass Surgery Works
Gastric bypass is a restrictive surgery technique that also alters the digestive process. The surgery restricts food intake by creating a smaller stomach pouch. It alters the body's normal digestive process by decreasing the amount of calories and nutrients the body is able to absorb. After surgery, food bypasses a large part of the stomach and most of the small intestine.
The Gastric Bypass Procedure
Gastric bypass surgery can be performed as an open procedure or a laparoscopic (minimally invasive) procedure. Laparoscopic surgery is performed using small incisions. This usually means a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures. Most surgeons prefer the laparoscopic approach.
First the surgeon creates a small stomach pouch. Then a section of the small intestine is attached directly to the pouch. This causes food to bypass a portion of the small intestine, where calories and nutrients are absorbed. Having a smaller stomach pouch causes you to feel full sooner and eat less food. Gastric bypass patients report an early sense of fullness and satisfaction that reduces the desire to eat.
One study found, following laparoscopic gastric bypass, patients were able to leave the hospital after 3 days and return to work after 21 days.
How a Gastric Sleeve Works to Help You Lose Weight
During this procedure a thin, vertical sleeve of stomach is created and the rest of the stomach is removed. The sleeve is about the size of a banana. This procedure limits the amount of food you can eat and helps you feel full sooner. It allows for normal digestion and absorption. Food consumed passes through the digestive tract in the usual order allowing it to be fully absorbed in the body.
The majority of gastric sleeve procedures performed today use a laparoscopic (minimally invasive) technique. Laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures.
The length of time of the surgery varies. One study found that the average operative time was 1.5 to 3.5 hours and the average hospital stay was 2 to 5 days. Patients usually return to normal activities in 2 weeks and are fully recovered in 3 weeks.
One-Step and Two-Step Gastric Sleeve Procedure
Gastric sleeve procedure can be the first step before gastric bypass or it can be a single procedure for weight loss. If it is used as part of a two-step procedure, the first step is for the surgeon to create the small stomach "sleeve." After a period of time determined by the surgeon, another procedure would be done in which the surgeon attaches a section of the small intestine directly to the stomach pouch. This allows food to bypass a portion of the small intestine. This causes your body to absorb fewer calories and consume less food.
The two-step procedure may be done because patients may not be able to tolerate both procedures during a single operation. Studies show the two-step procedure has been used successfully in patients with a body mass index greater than 50 or in high-risk patients.