Classification: Bariatric surgery; laparoscopic, therapeutic
Anesthesia type: General
Duration: 1 – 2 hours with additional 2 hours in the recovery room and 2 nights at hospital
Bariatric surgery is the term encompassing all of the surgical treatments for morbid obesity, morbid obesity is defined as a body mass index greater than 40 (The BMI is defined as the body weight (in kilograms), divided by the square of the height (in meters).The result is expressed as a number usually between 15 and 70). The Consensus Panel of the National Institutes of Health (NIH) recommended the following criteria for consideration of bariatric surgery, including gastric bypass
- People who have a BMI of 40 or higher
- People with a BMI of 35 or higher with one or more related comorbid conditions such as diabetes, hypertension and sleep apnea.
Gastric bypass surgery refers to a surgical procedure in which the stomach is divided into a small upper pouch and a much larger lower "remnant" pouch and then the small intestine is rearranged to connect to both.
Variations of the gastric bypass
- Gastric bypass, Roux en-Y(proximal)
- Gastric bypass, Roux en-Y (distal)
- Mini gastric bypass" (MGB)
- Endoscopic duodenal-jejunal bypass
Gastric bypass may cause complications:
- Anastomotic leakage
- Blood clots and infections
- Aversion to food and nausea
- Gastroparesis, with a delay in moving food from the stomach to the small intestine
- Esophageal spasm/pain
Most patients can achieve adequate calcium absorption by supplementation with vitamin D, Iron frequently is seriously deficient, particularly in menstruating females, and must be supplemented. Signs and symptoms of zinc deficiency may also occur such as: acne, eczema, white spots on the nails, hair loss, depression, amnesia, and lethargy. Deficiency of thiamine (also known as vitamin B1) and also Vitamin B12 which requires intrinsic factor from the gastric mucosa to be absorbed and both can be replaced orally. Many patients require protein supplementation during the early phases of rapid weight loss to prevent excessive loss of muscle mass, hair loss is also a risk of protein malnutrition. Folate deficiency is also a common occurrence in gastric bypass surgery patients. Vitamin A deficiencies generally occur as a result of fat soluble vitamins deficiencies, all of this can be avoided by oral supplementation and close monitoring in the first year.