1. Gastric Bypass: the most tested of the procedures available with the advantage of being laparoscopic

• The Gastric Bypass is the most utilized obesity treatment surgery. It has been in use for over 25 years.
  
  
• It is the most tested surgery with proven results that serves as a benchmark for the other procedures.
  
  
• When it is done via laparoscopy complications from conventional surgery are reduced significantly:
  
  
• Less respiratory, digestive, hernia and thrombosis problems after surgery. 
• Faster recovery time and better cosmetic results: only 5 small incisions without any sutures that need to be removed.
• Only 2-3 days of hospital admission.

2. What is the patient profile for this type of surgery?

• Patients with BMI > 45 and < 54 (this surgery should be considered in these cases).

• Patients who are always snacking and cannot control their food impulses as well as the ones who eat sweets very frequently and without control.

3. How does the Gastric Bypass surgery work?

It is divided in two main parts:

1. Create a smaller stomach (the rest of the stomach is responsible for the endocrine functions)
   (AS A RESULT THE PATIENT IS RESTRICTED TO SMALLER QUANTITIES OF FOOD PER MEAL)
   
2. Bridge the intestine so the biliopancreatic secretion and the food unite at about 75 to 200 cm from the stomach (BYPASS).
   (AS A RESULT THE PATIENT DOES NOT ABSORB PART OF THE FOOD CONSUMED)

4. What will I be able to eat after the Gastric Bypass surgery?

• During the first 4 weeks following surgery the patient needs a liquid and semi-liquid diet including food supplements.
  
  
• After that period, the patient needs to have an equilibrated diet, eat 5 times per day and usually avoid eating outside of meal times.
  
  
• Due to the bypass surgery, when the patient takes excessive fats or sweets, slight diarrhea can occur. The patient should control his/her food intake.
  
  
• In general, the patient can have a normal diet, in small portions, enjoying meal times personally and socially.

5. Bypass advantages:

• Quality of life in the sense that the patient can eat everything.
  
  
• Less effort required from the patient.
  
  
• Hunger control (because of the reduced Ghrelin hormone).
  
  
• Treatment success is more probable and weight loss is more significant than with other treatments.
  
  
• Very well tested and long term efficient procedure (over 25 years of surgery evolution).

6. Will I be in pain after the surgery?

Gastric bypass via laparoscopy is not typically bothersome for most patients.

After surgery, the patient:

• Can stand up and take short walks around the room 3-4 hours after surgery.

• Intake cold liquids 24-48 hours after surgery with a prior test.
  
  
•  Is released from the hospital 2-3 days after surgery.

• Has a normal life after hospital release except for extreme physical effort.

• Goes back to work / active life 7 days after surgery (except for intense physical exercise which needs to wait for 4-6 weeks).

7. How much weight can I lose with the Gastric Bypass surgery?

• The gastric bypass surgery is one of the most efficient weight loss treatments.
  
  
• Patients have an excess weight loss average of 70% - 80%.
  
  
• Most of the weight loss happens in the first 6-10 months.

8. Is the weight loss permanent?

• In most of the cases the weight loss is maintained for life.
  
  
• In cases where the patient’s diet is repeatedly excessive, part of the weight might be regained over the years.
  
  
• In the few cases of regaining weight, the patient can:
  
  
• Have an increase of the intestinal by-pass length.
• Have an adjustable gastric band placed on the by-pass stomach.

9. Gastric Bypass disadvantages:

• Partial loss of fat-soluble vitamins, B vitamins and other nutrients.
  
  
• The patient needs to take vitamins for life and annual check-ups are required.
  
  
• There is a potential risk of excessive weight loss.
  
  
• The surgical risk is higher than in other procedures (but via laparoscopy that risk is reduced significantly).

10. Risks and complications of Gastric Bypass:

In the immediate post-operation:

• Deep vein thromboses: 0.5%.
• Pulmonary thrombo-embolism, not deadly: 0.5%
• Anastomotic leakage: 1%
• Hemorrhage<1%
• Mortality rate: 1% (Gastric Band: 0.10%, Gastric Tube: 0.25%)

In the mid to long term post-operation:

• Dumping
• Stenosis of the stomach anastomosis-small intestine
• Anastomotic ulcer
• Bowel obstruction
• Iron, B12 Vitamin and Folic Acid deficiencies
• Diarrhea

11. Is the Gastric Bypass an appropriate surgery for me?

• Please check our section “What treatment do I need?”.
  
  
• Read the advantages and disadvantages of each surgical technique and typical patient profile for each type (see comparative table)

12. What support does Clínica Obesitas provide to Gastric Bypass patients?

Clínica Obesitas’ multi-disciplinary team will give you a support treatment including the following:

• Follow up with the surgical team.
• Dietetic education given by the nutritionist.
• Lifestyle changes –physical exercise according to each patient’s limitations and needs-.
• Support from the psychologist –cognitive behavioral therapy.

Clínica Obésitas offers a set of consultations and follow-up visits over a 24 month period that the patient can take advantage of.