Gastric Bypass

The procedure can usually be performed by laparoscopic (keyhole) surgery and takes approximately one hour. It is classed as major surgery and is not straightforward to reverse. Most patients stay two nights in hospital.

You need to be prepared to work hard after your surgery to make sure that you eat the right balance of nutrients. Your ability to digest food is impaired after surgery, and you need to make sure you do not develop malnutrition.  Your eating habits will change as they do after a sleeve gastrectomy.

• Weight loss following a gastric bypass is generally 70% of excess weight at two years. This is greater than that achieved with a gastric band or sleeve gastrectomy alone.
• If you have type 2 diabetes this can go into remission. This can happen within a day to up to six weeks following the surgery in most patients because insulin resistance is lowered.
• Sustained weight loss and benefits to health then depend on your commitment to maintaining a healthy diet and taking nutritional supplements for the rest of your life.

When we treat patients who are morbidly obese, with a BMI of 60 or higher, we use the sleeve gastrectomy as the first stage in a potentially two-stage weight loss treatment. The sleeve gastrectomy is the less risky of the two operations and can be done safely in people who are so obese.

In such patients, the tendency to over-eat is strong and the stomach is liable to expand after one to two years. However, the sleeve gastrectomy is able to bring about enough weight loss to bring their BMI down to around 50, which then makes it possible to perform a duodenal switch. This more complex surgery cannot be attempted in someone with a higher BMI.

Major complications include:

• Leakage at the junction between the stomach and the small intestine. General statistics show this occurs in one in 200 gastric bypass operations done in the UK though it is very rare with our experienced surgeons.
• Formation of peptic ulcers at these joins. Generally this affects one in 100 patients. Each patient should be monitored to detect and treat ulcers promptly.
• Internal hernias, which are extremely rare but can be serious.
• Dumping syndrome, which is very important to patients who have a sweet tooth. If you have a gastric bypass and you eat high-sugar food, the sugar rush directly into the lower part of the small intestine makes you feel light-headed and queasy. This happens because you produce a spike of insulin to deal with the sugar. The feeling that you get with dumping syndrome is so unpleasant that your brain is re-programmed to avoid sweet foods.