Prior to any weight loss operation, your doctor will give you a complete medical examination and evaluate your overall health.
A psychological evaluation will be given to you. This will determine whether you are ready to adhere to a healthier lifestyle. If you are not ready to make lifestyle changes (and have not tried hard to do so already), you will not be considered eligible for the procedure. Without changing your lifestyle, the surgery will not be a success.
You will also receive extensive nutritional counseling before (and after) your surgery.
The surgery is performed under anesthesia. There are two basic steps:
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STEP 1 -- The first step in the surgical procedure makes your stomach smaller. The surgeon divides the stomach into a small upper section and a larger bottom section using staples that are similar to stitches. The top section of the stomach (called the pouch) will hold your food.
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STEP 2 -- After the stomach has been divided, the surgeon connects a section of the small intestine to the pouch. When you eat, the food will now travel from the pouch through this new connection ("Roux limb"), bypassing the lower portion of the stomach. The surgeon will then reconnect the base of the Roux limb with the remaining portion of the small intestines from the bottom of the stomach, forming a y-shape.
This "y-connection" allows food to mix with pancreatic fluid and bile, aiding the absorption of important vitamins and minerals. You still may experience poor absorption of certain nutrients.
The risk of malabsorption is of greater concern in gastric surgeries that skip over a larger portion of the small intestines. These are performed much less commonly than the Roux-en-Y gastric bypass as described.
LAPAROSCOPY
Gastric bypass can be performed using a laparoscope. This less-invasive technique allows the surgeon to make smaller incisions, which lowers the risk of large scars and hernias after the procedure.
First, small incisions are made in your abdomen. The surgeon passes slender surgical instruments through these narrow openings. The surgeon also passes a camera (laparoscope) through one of these small openings and watches through a lens and video monitor to do the surgery.
OTHER TYPES OF WEIGHT LOSS SURGERIES
Surgeries for weight loss are classified into two categories:
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Restrictive procedures reduce the size of your stomach.
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Malabsorptive procedures reduce the size of your stomach, plus they cause the poor absorption of calories, vitamins, and minerals.
Gastric bypass is a malabsorptive procedure. This type of surgery is more successful for weight loss than restrictive surgeries, but your body may not absorb vitamins and minerals properly.
Restrictive surgeries are performed less often. The small stomach pouch is created using bands (known as gastric banding) and/or staples (often called "stomach stapling"). The surgeon leaves a narrow passage in the newly created pouch so that food can still go through the remainder of the stomach and small intestines. Only, it does so much more slowly.
Restrictive procedures are not as successful. It is easy to "cheat" and eat too much food, over-stretching the newly created stomach pouch.
