What happens to the bypassed stomach?
The only change that appears to be of clinical significance is a marked decrease in the production of ghrellin and a consequent marked decrease in hunger sensations.
How is laparoscopic gastric bypass different than open gastric bypass?
Laparoscopic gastric bypass is accomplished with 5 small incisions rather than one long incision. A camera is placed through one of the incisions and long instruments through the others. The operation is performed while watching a video screen. The actual operation on the stomach and intestine is the same with both approaches.
The gastric bypass open incision is approximately 3/4 of the distance from the breastbone to the belly button. That is about 4-5 inches in some people and as much as 15 inches in others.
Is laparoscopic gastric bypass safe?
Many studies done by experienced laparoscopic bariatric surgeons have demonstrated laparoscopic gastric bypass to be safe. Laparoscopic gastric bypass is technically demanding and studies show that the amount of experience a surgeon has contributes to safety.
How does laparoscopic gastric bypass compare to open gastric bypass?
Laparoscopic gastric bypass results in a shorter hospital stay, less pain, less scarring, and a quicker return to usual activities. Complications such as wound infections and wound hernias are nearly eliminated with the laparoscopic approach. The risk for serious complications (such as leak) is similar with both laparoscopic and open gastric bypass.
Why aren’t all gastric bypasses done laparoscopically?
Laparoscopic gastric bypass is a difficult operation to learn to do safely. It also takes longer and is more expensive. The result is that most gastric bypasses in the United States are done open at this time. For most patients laparoscopic surgery is better (less pain, shorter hospital stay, less scarring, quicker return to usual activities). As more surgeons learn to do laparoscopic gastric bypass safely and patients demand it, more laparoscopic gastric bypasses will be done.
Can the surgery be reversed?
Yes, but it would take another operation. No one, in my experience, has asked to have the surgery reversed.
What are the main risks of surgery after gastric bypass?
Put simply the main risks are death and complications. Mortality risk reported across the US is 0.5% or 1 patient in every 200. By recent count our mortality risk is less than one patient in every 500 gastric bypasses. The commonest causes for death are pulmonary emboli and infections. The commonest complications are wound infections, strictures, and hernias. The risks after adjustable band surgery and after gastric bypass are different (see Information Seminar). The major problems that occur with any frequency after gastric bypass are 1) leakage from the bowel connection to the pouch, 2) pulmonary emboli, 3) bowel obstruction or kinking, 4) bleeding, 5) stricture. The major problems after an adjustable band are 1) erosion, 2) slippage or herniation of the stomach up through the band, 3) pulmonary emboli, 4) esophageal dilatation.