Gastric Bypass Perth
What is gastric bypass surgery, and are you a candidate?
Gastric bypass surgery is a technique in which the stomach is divided into a small upper pouch and a much larger ‘remnant’ pouch. The small intestine is then rearranged to connect directly to the small stomach pouch, meaning swallowed food ‘bypasses’ most of the stomach and a portion of the small bowel. As a result, less calories are able to be absorbed after eating.
Perth Obesity Surgery offers two forms of gastric bypass surgery: the traditional laparoscopic Roux-en-Y procedure and mini gastric bypass surgery. Both have their advantages and disadvantages, and suitability may differ from one individual to another.
Roux-en-Y Gastric Bypass
Considered the “gold standard” bariatric operation, the Roux-en-Y has proven to be a reliable weight loss solution. The reconfiguration of the small intestine connected to the newly formed small stomach pouch also means about 1 metre of intestine has no contact with food while another metre contacts food but without digestive juices to aid adsorption.
Roux-en-Y is most often keyhole surgery, although at times an open procedure may be necessary. It is not suitable for people who smoke or take medicinal steroids (corticosteroids).
Mini Gastric Bypass
Mini gastric bypass surgery is keyhole surgery with five small incisions. A long, thin pouch (similar to the gastric sleeve) is fashioned with a new opening that is then joined to the small intestine. One join is made, then some sutures are used to configure everything into gentle curves to direct the flow of food.
This procedure achieves more restriction through a different type of gastric pouch along with a better metabolic effect through a slightly longer length of bypassed bowel (about 2 metres).
Mini gastric bypass surgery avoids some problems associated with the more complicated Roux-en-Y procedure and has shown success for patients with significant weight to lose (with a BMI above 40) and particularly those with diabetes and/or other metabolic disorders.
Unfortunately, this option is not offered for patients who smoke or use corticosteroids and can aggravate bowel frequency in people who are susceptible.
What are the risks of gastric bypass surgery?
While uncommon, gastric bypass surgery risks can include blood clots (blood thinners can reduce this risk); vitamin deficiency (B12, iron and protein particularly); bile reflux requiring surgery to fix (5% of surgeries); stricture (narrowing) or ulcer at the join (5%); and leakage from the staple line (0.5%).
Other gastric bypass side effects could include gallstones and dumping syndrome, a condition in which abdominal cramps and diarrhoea can occur shortly after eating.
What is the expected recovery time after gastric bypass surgery?
As the procedure is generally keyhole surgery, pain is minimised, and patients may feel better after a couple of days. The average hospital stay is two nights and total recovery time is usually about three weeks. Most patients will not require any analgesics other than paracetamol after discharge from hospital.
Following surgery, patients must commit to taking multivitamins for life and having particular vitamins checked regularly through blood tests as malabsorption can have detrimental effects on a patient’s long-term health outcomes.
How does gastric bypass surgery compare to other weight loss surgery options?
Three-year data has demonstrated both weight loss and diabetic control are greater in mini gastric bypass surgery than gastric sleeve surgery, and even the Roux-en-Y bypass procedure.
A small number of patients suffer from bile reflux after a mini bypass which is most often treated by converting to a Roux-en-Y bypass. That conversion is much easier than the initial procedure but is still an operation. There would be no extra out of pocket expense with the second surgery
There is less open spaces behind loops of bowel for pieces of bowel to get caught, creating internal hernias in a mini bypass which can be an issue for the Roux-en-Y procedure. Surgery time is also quicker for mini gastric bypass surgery. These are the reasons that you would usually be recommended this procedure rather than a Roux-en-Y.
Although considered a very reliable weight loss solution, disadvantages of bypass surgery include the degree of nutrition challenges. This can usually be overcome by taking multivitamins for life and is more of a concern when a longer length of bowel is bypassed. Weight regain is also still a challenge weight regain of 10-20% after 2-5 years is reported in some studies.
Gastric bypass surgery is generally considered a great revision procedure and in addition to weight loss, it is also effective for managing reflux.
How much does gastric bypass surgery cost?
The total gastric bypass surgery cost may comprise of the Medicare rebate, a private health fund rebate, and an out-of-pocket cost.
Perth Obesity Surgery is committed to providing an accurate assessment of a patient’s situation from the initial consult, complete with an explanation of all charges involved. We charge a once-off, all-inclusive fee that covers the costs involved from the day of your initial consultation through to post-operative care.
More information on our weight loss surgery costs can be found here.
Not sure if gastric bypass surgery is the right choice for you? Book a consultation with a Perth Obesity Surgery bariatric surgeon for a personalised care plan.