The Obesity Treatment CenterThe Surgical OptionWhat is Gastric Bypass? Printer Friendly Page

One of these early procedures–the jejuno-ileal bypass, or "intestinal bypass," as it was commonly called–had serious complications: severe diarrhea, loss of essential nutrients, and in some cases, acute liver failure. This procedure is mentioned only because it is similar in name to gastric bypass: the two surgeries are not the same. In fact, "intestinal bypass" is no longer a recommended bariatric surgical procedure.

The surgical options today fall into two general categories: restrictive operations and gastric bypass. Restrictive procedures, such as gastric banding and vertical banded gastroplasty, restrict food intake by creating a small pouch in the stomach with a band made of a special material.

The Obesity Treatment Center (OTC), a program of University Hospital and New Jersey Medical School, utilizes the Roux-en-Y gastric bypass, a highly effective method to achieve permanent weight loss. It is performed in the traditional "open" manner or laparoscopically, depending upon each patient's individual circumstances.

During gastric bypass, performed as an "open" operation or with a minimally invasive technique using laparoscopes, a small pouch is created at the top of the stomach, to which the small intestine is connected. The newly created pouch initially can hold about two ounces of food; over time, there can be some increase in the size of the pouch. A regular-sized stomach has a capacity of nearly one quart. With a smaller stomach, the patient feels "full" sooner and is less likely to overeat. By eating small amounts of food very slowly, the patient is able to reduce caloric intake.

Gastric bypass surgery also reduces the body’s ability to absorb calories and certain nutrients. The type of food eaten after surgery changes–and usually for the better. Most patients find that it is more difficult for their body to digest foods high in refined sugar and fat, and thus opt for healthier choices.

While gastric bypass surgery often results in substantial weight loss, post-operatively, it is not always an easy regimen for people to follow. Patients considering the procedure at University Hospital are requested to have a psychiatric consultation to be sure they can tolerate the rigors of the operation and the post-operative requirements. They will also be interviewed by a nutritionist, who will explain the dietary modifications that the operation requires.

As with any surgery, there are possible risks with gastric bypass. One of the most serious is leakage at the area where the stomach pouch meets the small intestine. The condition most often becomes evident while the patient is still in the hospital; another surgery may be required to repair the leak.

With no treatment, one in four gastric bypass patients will develop gallstones following surgery. During the procedure, the surgeon will check the gallbladder for stones. However, some are too small to be detected, and others simply develop following weight loss. That is why a bile thinning medication is prescribed after surgery.

Other complications include abdominal hernias, wound infection, small bowel obstruction, fever, and abdominal tenderness. There is also the possibility of lung-related conditions, such as pulmonary embolism, and additional stress on the cardiac system. In very rare situations, patients die as a result of the surgery.

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