What is gastric bypass?
Gastric bypass (more precisely: Roux-en-Y gastric bypass) is a very frequently used method of obesity surgery with the aim of weight reduction. The name is derived from the name of the Swiss surgeon “Roux”, who developed the basic technique of the procedure. The “Y” stands for the shape in which the intestinal sections are connected, namely Y-shaped.
The success of gastric bypass is based on two principles:
- the elimination of the important upper part of the small intestine (duodenum), as a result of which the digestive juices, which are important for breaking down food, mix with the food pulp at a later stage (poorer absorption of nutrients = malabsorption)
Preparation for gastric bypass
Procedure of the gastric bypass surgery
Gastric bypass surgery takes about 90 to 150 minutes, depending on the patient, and is performed under general anesthesia. The procedure usually requires a hospital stay of about one day before the surgery (surgery and anesthesia preparation) plus five to seven days afterwards. After gastric bypass surgery, you will not be able to work for about three weeks.
Gastric bypass surgery consists of several stages:
- After induction of general anesthesia, the surgeon introduces the instruments and a camera with a light source into the abdominal cavity through several skin incisions. Then a gas (usually CO2) is introduced into the abdominal cavity so that the abdominal wall lifts slightly from the organs, giving the surgeon more space in the abdomen and a better view of the organs.
- Next, an incision is made through the small intestine in the area of the so-called jejunum (“empty bowel”). The lower end of the incision is now pulled up and sutured to the gastric pouch. The connection is therefore also called gastrojejunal anastomosis.
For whom gastric bypass is suitable
Gastric bypass is particularly recommended for people whose excess weight is mainly due to heavy consumption of high-calorie food (sweets, fats) and sweet drinks. This is because these are now broken down more poorly and can therefore only be utilized by the body to a small extent and stored as body fat.
For whom gastric bypass is not suitable
Various physical and psychological illnesses speak against obesity surgery such as gastric bypass. Especially after previous operations or malformations of the stomach, stomach ulcers and addictive diseases as well as untreated eating disorders such as “binge eating” or bulimia, a gastric bypass must not be performed. Pregnant women must also avoid gastric bypass.
Effectiveness of gastric bypass surgery
Advantages of gastric bypass over other procedures
Side effects
There are some side effects associated with gastric bypass. How severe these will be varies from individual to individual and therefore cannot be predicted with certainty. The important ones include:
Indigestion due to malabsorption: flatulence, abdominal pain, nausea, bloating.
Vitamin D deficiency: Why gastric bypass can lead to vitamin D deficiency has not yet been clarified. Vitamin D can be supplemented without problems through the diet (orally).
Gastric ulcer in the gastric pouch: After gastric bypass surgery, the risk of a gastric ulcer in the gastric pouch is increased. Acid-reducing drugs, so-called proton pump inhibitors (PPI), which must be taken permanently, can help if a gastric ulcer develops after gastric bypass surgery.
Gastric bypass: risks and complications
Gastric bypass is a major abdominal surgical procedure that greatly alters the normal anatomy of the gastrointestinal system. In principle, the surgical risk is low, but complications cannot be ruled out, as with all surgical procedures. Nonspecific surgical risks include:
- Anesthetic complications
- @ Organ and vascular injuries with bleeding
- Infections of the internal and external wounds
- Wound healing disorders
- Disorders of normal gastrointestinal movements (intestinal atony)
Gastric bypass: diet after surgery
People with gastric bypass must follow the following dietary rules for life to avoid digestive problems:
- Chew food very well
- eat small portions
- avoid foods and drinks with high sugar content
- avoid very long fibrous meat or vegetables
- take food supplements (see above)
Medication after gastric bypass
Gastric bypass: costs
The costs for a gastric bypass vary, in some cases quite considerably, depending on the clinic. They range from about 6,500 to 15,000 euros. The gastric bypass is currently not yet a standard benefit of the statutory health insurance. This means that the costs of gastric bypass are only covered upon application and only under certain conditions. Inform yourself in detail about the necessary requirements before applying!
