The Gastric Bypass

The procedure is carried out laparoscopically (keyhole) with the first step being the creation of a small stomach pouch about the size of your thumb! Next a part of the small bowel is attached to the stomach pouch using a combination of staples and sutures. A second join is made between two parts of the small bowel and the joins then test by squirting blue dye into the gullet checking forleaks. The small bowel is divided and the operation completed.

When you see the pharmacist for your pre-operative assessment you may have your regular medications converted to liquid form and /or given instructions to crush tablets to allow easier ingestion.

Complications

Death The gastric bypass has an anticipated death rate between 1 in 200 and 1 in 500 operations. Male gender, the existence of co-morbidities and a BMI>50 increase the risks.

Bleeding and infection (chest, wound, urine)-common to any operation performed.

Deep Venous Thrombosis and Pulmonary Emboli Obese patients have a higher risk of deep venous thrombosis (DVT)which are blood clots developing in the leg veins. These clots can break away and circulate into the lungs as a pulmonary embolus (PE). We do our best to significantly reduce the chance of this happening by prescribing medicine to thin the blood. This is givenbefore your operation, whilst an inpatient and up to 10 days after you have left hospital. We will teach you to give it yourself as an injection or make arrangements for it to be given. You will also befitted with special gradated calf stockings.

Anastomotic leaks Any surgery that involves the cutting and joining together of bits of bowel is at risk of leaking. Even if the blue dye test is ok leaks can occur that require a return to the operating theatre to fix.

Hair loss Rapid weight loss is associated with hair thinning. No patient hasever gone bald and as your weight stabilises the hair returns.

Vitamin deficiencies Because the upper small bowel is bypassed this leads to a decreased absorption of iron that can cause anaemia and a decreased absorption of calcium that can lead to weak bones. This can be avoided by taking regular vitamin supplements, sticking to a proper diet and attending for follow up appointments.

Dumping syndrome This occurs when food in the stomach rapidly empties into the small bowel. This is usually initiated by the ingestion of too much sugar or too large a volume. The symptoms include nausea, weakness, sweating, faintness and occasionally diarrhoea! Be warned sweeteaters!

Internal hernias By changing the configuration of the bowel potential gaps can occur which predispose to internal hernias. This is very uncommon but is aknown cause for abdominal pain post bypass surgery and may require corrective surgery. We now always close such gaps at the time of surgery.

You may not feel hungry following surgery and this is normal but it is important that you eat and drink regularly as directed by the dietitian.Eat slowly and follow the advice of the dietitians wrt type of food, texture, speed of eating and volume of food ate.

Contraception The best means of contraception for females is either an intrauterine coil or a depot injection.