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Gastric bypass surgery is
an operation that is done to
help treat 'severe' obesity. Its
goal is to help you lose weight by
limiting the stomach 's ability
to store large amounts of food.
However, it's important to understand
that undergoing this surgery does
not mean that you will no longer have
to think about food choices or significant
lifestyle changes.
Remember, obesity is the result
of an interaction between
biology and behavior.
Patients who have this serious surgery must
be prepared to make significant changes
in eating and lifestyle patterns - changes
that will last a lifetime. Bypass surgery
provides the extra help most people
with extreme obesity need.
The surgery gives your body a new
way of digesting food, which
becomes part of a comprehensive health plan
that includes other components such
as regular exercise, healthy food
choices, and close, ongoing contact
with members of your health care team.
It does this by changing the way
food passes through the stomach
and intestines.
Gastric Bypass Surgery is
a specific type of surgery designed
to treat people who are so overweight
that they are suffering health consequences
of the excess weight.
The operations employed for morbid obesity are
not to be confused with plastic surgery -
weight loss surgery involves
substantial and permanent changes
in the patient's stomach and
other gastrointestinal physiology.
Real risk comes with each surgical
procedure, and surgery is only offered
to those whose weight is high enough
that the medical risk of continued
obesity outweighs the risk of surgery.
Prospective patients should also
be thoroughly convinced that they
have exhausted all other reasonable
avenues of weight loss before
selecting surgery.
(RNY) Gastric Bypass
The Roux-en-Y is considered 'the
Gold Standard' for Gastric Bypass
surgery.
During this operation, the surgeon separates
the stomach with a special
stapling device into two sections.
This creates a small working section
on top, called a pouch, connected
to the esophagus . This pouch will
become the new stomach and is constructed
to contain only 1 ounce of food(picture
a hard-boiled egg).
The rest of the stomach, the larger 'left
over' bottom section, is completely
disconnected from the pouch and
remains where it normally is but no
nutrient sever enter it.It
is alive and healthy and still secretes
acids and other gastric juices, which
flow into the intestines to
aid in digestion and it makes
intrinsic factor, necessary to absorb
Vitamin B12 .It also
contributes to hormone balance
and motility of the intestines in
ways that are not entirely known.
In some cases it may shrink a bit
and its lining (the mucosa ) may contract,
but for the most part it remains unchanged.
The new pouch is then stapled
to a segment of the intestine so that
the food travels from the mouth,
down the esophagus through
the pouch directly into the intestine,
bypassing the majority of the 'left
over' bottom section. Inside
this new connection between the pouch
and the intestine, a small 'hole'
or 'tunnel' is created for the food
to pass through.This 'hole'
is called a stomaand is deliberately
made very small in diameter (picture
a drinking straw) to slow down the
movement of food from the pouch out
into the intestine.
The staples used on the stomach and
the intestines are very tiny
in comparison to the staples you normally
use in the office. Each staple is
a tiny piece of stainless steel or
titanium so small it is hard
to see other than as a tiny bright
spot. Because the metals used
(titanium or stainless steel) are
inert in the body, most people are
not allergic to staples and
they usually do not cause any problems
in the long run. The staple materials
are also non-magnetic, which means
that they will not be affected by
MRI nor will they set off airport
metal detectors .
The RNY gastric bypass surgery is
a very successful operation for
weight control and tens of
thousands are performed yearly in
the U.S.A. Patients eat smaller
amounts of food, feel fuller sooner,
have less of an appetite and, with the laparoscopic
approach, suffer less pain and run a lower risk
of developing hernias .
How
Weight Loss is Achieved with the RNY
The operation produces a number of changes
in how your body digests food . These changes, in
combination with an overall plan of diet and
exercise, can help you lose a significant amount
of weight in several ways:
- You now have a smaller stomach - The
small "pouch " created during the operation is
your new stomach. It can only hold about 3 ounces
of food or liquid at a time. (Normally, the
stomach can hold up to 50 ounces.) A much smaller
stomach means it takes a much smaller amount of
food to make you feel full .
- Slower digestion - Because
of the small opening connecting the pouch to
the intestines(the stoma ), food moves
through the system very slowly after it is eaten,
making you feel full longer.
- Hormone changes - Your
body makes hormones that contribute to your feeling
full after a meal. The changes in the way
food enters the intestines after surgery affects
these hormones, which may also help you feel full
for a longer period. Hormone changes are also responsible
for the "dumping syndrome " - a side effect of
surgery that is explained below, but that can also
contribute to rapid weight loss in the months following
surgery.
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