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    Bariatric/Obesity Surgery :

Laparoscopic Gastric Bypass Surgery:

The gastric bypass is the surgery more frequently used to neutralize morbid obesity, to recover health and to begin to enjoy the life under the same conditions as the rest of society.

Which are the comparative benefits of the Gastric Bypass?

It produces less vomits than other procedures.

Some history

The gastric bypass has traveled a long road until becoming the surgery to combat obesity more frequently carried out in our days.Since stomach surgeries started to be carried out, it was observed that patients that were subjected to the extirpation of a part of their stomaches because of gastrointestinal ulcers, lost weight in a significant way after the operation. However, some decades went by till in 1966 the first steps were taken to give a practical application to that loss of weight, through a technique that reduced the stomach capacity. This technique was relatively similar to the one that is used nowadays.Before that date all the attempts presented risks and unacceptable complications so they were discarded. The main difference among those first surgeries and those that began to be used in the decade of 1990, is that the first ones were carried out through open techniques, that means through a wide wound that allowed a direct vision of the area to be treated, while the current ones are carried out through laparoscopic techniques.These techniques consist of the use of special instruments that are introduced through minimum incisions, so that the observation of the treated area is made on a closed-circuit monitor. The incisions of less than 0.39 inches (1 cm) wide that are used nowadays produce a lower surgical trauma and a milder postoperative pain.

These two important advances, added to the reduction of the risks and postoperative complications, explain why every day more people decide to have a gastric bypass, when another type of treatments is not successful to achieve an effective and durable weight lost.Numerous studies carried out by world medical associations under the advice of the World Health Organization (WHO) have demonstrated that all the treatments to combat severe or morbid obesity which are not based in surgical techniques (as diets or medication) fail in 98% of the cases at maintaining the obtained loss of weight for a long-term.

How is a Gastric Bypass surgery performed?

The technique that is used to carry out the gastric bypass is known as 'Roux-en-Y ' due to the form of a Y that it is given to the new circuit of food circulation through the surgery.In normal stomaches that have not been operated, foods are subjected to the action of the gastric juices and then they pass to the intestine. Through the gastric bypass this part of the process is avoided.By a suture line the stomach is divided in two parts: the upper and lower bag. These two bags have very different sizes: the upper one receives the ingested food and occupies only 10% of the stomach capacity, while the lower bag has the remaining 90% and is completely isolated from the passing food. The thin intestine is intersected at 15.75 inches (40cm) of the stomach exit and it is connected with the small and recently created upper bag, so that food passes directly to the intestine without being processed by the gastric juices that are in the large lower bag. The intestine portion that remains connected to the stomach exit by one of its extremes is connected by its other extreme (where the cut has been carried out) to the intact part of the intestine, approximately a meter ahead. Through this intestine tract, the big stomach bag will discharge the acids and the gastric juices that will meet the bile and the food, having skipped one meter of the intestine absorptive area.

Before Gastric Bypass surgery: Tips

Before considering a bariatric surgery or a the gastric bypass, it is important that you keep some points in mind:

You should be 18 years of age or older. Your doctor should discard that the obesity has appeared as consequence of another illness that canbe treated in other ways. Your Body Mass Index (BMI) must be higher than 40 or at least higher than 35 if you suffer any illness associated with morbid obesity. You should have lived at least 5 years with those indexes and have failed in every intent of losing weight with non-surgical treatments. Take a time to meditate about the important changes that will take place in your feeding habits after the stomach capacity is reduced. Get mentally ready to maintain these changes for the rest of your life. Keep in mind that you won't be able to drink a lot of alcohol. If you drink alcohol in excess, it is possible that you are not a good candidate for this surgery.

After Gastric Bypass surgery: Tips

A small adhesive bandage will cover each one of the 7 wounds of 1cm. You will also have two drainage tubes connected to airtight plastic bottles. One will be removed the third day after the surgery and the other one the seventh day.

Amount of pain
Mild to moderate

Seven scars of only 1cm long will be distributed on your abdomen, drawing a rhombus whose inferior tip will be in the navel and the superior in the base of the breastbone.
Removal of the stitches 7 to 10 days after the surgery.

You will be able to get up of bed and to walk some steps 2 hours after the surgery. At the beginning you will feel nuisances at making efforts that involve the abdominal area, but very quickly the pain will be reduced.

Risks and complications of the gastic bypass
Every surgical procedure, regardless of its triviality, has some risks and we should always think of them as a possibility. The gastric banding is a major surgery that is not an exception to this rule. The average index of immediate post-operative complications is approximately 2%.

The main immediate complications are:

Filtrations through the sutures that reduce the stomach capacity or reorient the food circulation through the intestine. This complication can require additional surgeries to be corrected. Respiratory problems.
Hemorrhages in incision and/or suture areas. Acute dilation of the gastric remanent. Intestinal obstruction. Blood clots that can be developed in the legs or other parts of the body and move to the lungs, with risk of causing pulmonary embolism thrombolysis.

Feeding after the gastric bypass:

After the application of the gastric banding it is very important that you dedicate special attention to chewing. You will be able to eat the foods that you like more, if they don't make you feel bad. However, keep in mind that the size reduction of your stomach will force you to eat in small quantities, and that therefore you will prioritize those foods that are rich in nutritious as vitamins. If you fill your stomach with high caloric Foods and few nutrients, as sugar and fat, it is probable that that diminishes the beneficent effects obtained with the operation. If the daily foods are insufficient in vitamin and minerals, it is possible that you will need to take some supplement in form of pills. You will assume that if you eat in other people's company you will no longer be able to follow the rhythm of the others. Some of the patients that have been operated in the past, consider that it is better to order a small portion of something healthy and to make it last while the other diners finish their meals. If you are entertained with a dinner, for example, perhaps you should explain that you are not rejecting the treat, but your stomach has a very limited capacity. You will surely develope your own habits and you will know what to do in order to feel comfortable in each situation.


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