GASTRIC BYPASS

General Information

DEFINITION--Creation of a digestive passage that bypasses most of the intestinal tract.

BODY PARTS INVOLVED--Stomach; small intestine.

REASONS FOR SURGERY--Extreme obesity.

SURGICAL RISK INCREASES WITH

• Stress; smoking.
• Poor nutrition.
• Recent illness.
• Alcoholism or chronic illness.
• Use of drugs such as: antihypertensives; muscle relaxants; tranquilizers; sleep inducers; insulin; sedatives; beta-adrenergic blockers; or cortisone.
• Use of mind-altering drugs.

What To Expect

WHO OPERATES--General surgeon.

WHERE PERFORMED--Hospital.

DIAGNOSTIC TESTS

• Before surgery: X-rays of upper gastrointestinal tract; blood and urine studies.
• After surgery: Blood studies.

ANESTHESIA--General anesthesia by injection and inhalation with an airway tube placed in the windpipe.

DESCRIPTION OF OPERATION

• An incision is made in the abdomen.
• The abdominal muscles are divided and the peritoneum is opened.
• The upper stomach is stapled across to isolate and close a section of stomach. A small opening made in the open section of stomach is joined to the lower small bowel so that digestive flow will bypass 90% of the intestinal tract.
• The peritoneum is closed and abdominal muscles are sewn together. The skin is closed with sutures or clips, which usually can be removed about 1 week after surgery.

POSSIBLE COMPLICATIONS

• Excessive bleeding.
• Surgical-wound infection.
• Diarrhea.
• Inadvertent injury to liver or spleen.
• Malnutrition.
• Infection in the bypassed segment.
• Intestinal obstruction.
• Dumping syndrome.

AVERAGE HOSPITAL STAY--7 to 10 days.

PROBABLE OUTCOME--Patients lose an average of 8 to 10 pounds per month for 6 months, then less afterwards. However, weight seldom drops below the ideal level unless severe complications develop.

Postoperative Care

† Move and elevate legs often while resting in bed to decrease the likelihood of deep--vein blood clots.

Vitamin B--

12 injections.

• You may use non-prescription drugs, such as acetaminophen, for minor pain.

† To help recovery and aid your well--

being, resume daily activities, including work, as soon as you are able.

• Avoid vigorous exercise for 6 weeks after surgery. Resume sex when you feel able. > Resume driving about 1 month after returning home.

DIET---

Your doctor may prescribe:

• Supplements of vitamins and electrolytes. > Low-fat diet (see Appendix).

Call Your Doctor If

† Pain, swelling, redness, drainage or bleeding increases in the surgical area.

• You develop signs of infection: headache, muscle aches, dizziness or a general ill feeling and fever.
• You experience nausea, vomiting, constipation or abdominal swelling.
• Symptoms of dumping syndrome (see in Illness section).
• New, unexplained symptoms develop. Drugs used in treatment may produce side effects.