Obesity surgery offers morbidly overweight patients an effective tool for rapid and controlled weight loss. Gastroplasty, or stomach surgery, now replaces plastic surgery. In addition to the installation of a gastric band, the technique of gastric bypass is developing. This surgical procedure modifies the food circuit by introducing a derivative duct which notably reduces the volume of the stomach.
MECHANISMS OF GASTRIC BYPASS
To lose weight, gastric bypass combines several mechanisms. Like gastroplasty, which is the operation dedicated to the installation of a gastric band, gastric bypass leads to a restriction effect. In other words, satiety, the feeling of no longer being hungry, occurs much more quickly. By being less hungry, the patient ingests less food, which results in weight loss.
By being less hungry, the patient ingests less food, which results in weight loss.
Other processes are set up with a bypass such as malabsorption. Food is less digested and therefore less stored. Sweet products are also less tolerated by the body, which causes a feeling of discomfort. This feeling of the patient forces him to turn away from a diet that favors sugars, which again accelerates weight loss. Finally, as with sleeve gastrectomy, the level of ghrelin, the hunger hormone, decreases. The patient notices a certain lack of interest in food, which again goes in the direction of weight loss. Be careful, however, because this last mechanism is useless in the event of compulsive behavior.
GASTRIC BYPASS: PROCEDURE
The objective of gastric bypass surgery is to divert the flow of ingested food from the stomach. These are received by a near gastric, created by stapling in the upper part of the stomach. A food loop deviates, like a derivation, the path of food which means that a large part of the stomach no longer receives it. This derivation is then reconnected to the biliary loop, which is the natural conduit connected to the rest of the digestive circuit.
This surgical operation is performed laparoscopically and the operating time is longer than a gastroplasty since it takes an hour and a half on average. Note that the rest of the stomach and the bile duct are no longer accessible to perform an endoscopy. The complexity of this intervention generally makes hospitalization longer, between four and six days.
Finally, gastric bypass surgery is difficult to reverse. Decision-making must therefore be considered, taking into account the advantages and disadvantages. However, a recent surgery offer, the mini gastric bypass, admits total reversibility. Similar in operation, it can be a new solution even if the long-term results are less known.
GASTRIC BYPASS: WHAT CONSEQUENCES?
» The weight loss following gastric bypass is very important
This surgery is also recommended for patients who have a body mass index (BMI) greater than 45. During the first six months, scientific hindsight and observed experiences predict a loss of around five kilos per month. Thereafter, this monthly drop is between two and four kilos. Thus, gastric bypass demonstrates convincing results: 70% of excess weight disappears in one year.
For the proper management of this weight loss, monitoring and medical supervision are obviously essential. Indeed, undernutrition is not uncommon, as is the appearance of vitamin deficiencies. Oral supplements are therefore to be expected in order not to generate deficiencies that are too dangerous for the body. As with other stomach surgeries, eating habits must be planned and followed: three meals for two snacks. Snacking is to be banned because it is a serious factor of failure. On the other hand, the gastric bypass option proves to be more comfortable than gastroplasty with regard to vomiting, which is rarer.
Postoperative medical follow-up is traditionally multidisciplinary. In addition to reassuring the patient about the impact of the bypass, blood tests, which are regular for the first year, check and identify any deficiencies.
The decision in concert with the medical follow-up must necessarily evoke the advantages as well as the disadvantages.