The surgical procedure known as bariatric gastric bypass is a way to achieve major – and hopefully permanent – weight loss. It is also a potential remedy for type 2 diabetes and other health conditions related to morbid obesity. Statistics show that gastric bypass surgery can help people as much as 90 percent of their excess body weight.

This operation works by modifying the stomach to limit food intake and suppress appetite. If you have an obesity-related medical condition, you may be able to lose weight and improve your overall health by undergoing bariatric gastric bypass surgery.

Gastric bypass surgery helps you lose weight by changing how your stomach and small intestine digest the food you eat. After the surgery, your stomach will be smaller, so that you will feel full even though you are eating less food.

Moreover, the food you eat will no longer go into certain areas of your stomach and small intestine. Since your stomach and intestines aren’t completely digesting the food, your body will not absorb all the calories.

Gastric bypass can be done in two ways. The first way is for your surgeon to make a large incision in your belly. Your surgeon will then reach inside and perform  the bypass by directly moving around your stomach, small intestine, and other organs.

The second way to do bariatric gastric bypass is to use a tiny camera, or laparoscope. This is called laparoscopic bariatric surgery. First, the surgeon will make several small incisions in your belly. Then he or she will pass the laparoscope through one of these incisions.

The laparoscopic stomach camera will be connected to a video monitor in the operating room, and your bariatric surgeon will look at the monitor to see inside your belly. Using thin surgical instruments, the doctor will then perform the gastric bypass.

Gastric Bypass Surgery: The Basics

There are two basic steps involved for each type of gastric bypass:

• Step One: This reduces your stomach size. Your bariatric doctor will use staples to separate your stomach into a small upper section and a larger bottom section. The top section of the stomach is called the “pouch” and this is where the food you eat goes. This pouch is about the size of a golf ball. It holds only about 1 ounce of food.
• Step Two: This is the bypass itself. Your gastric surgeon will connect the jejunum, which is a part of your small intestine, to a small hole in your pouch. The jejunum is located farther down from where the stomach normally attaches to the small intestine. Food consumed will now move from the pouch into this new opening into the small intestine.

When food travels this way, it “bypasses” the lower part of your stomach and the first section of the small intestine. As a result, your body will now absorb fewer calories.

Gastric Bypass: What are the Risks?

Gastric bypass surgery usually takes about 4 hours, and is followed by several days of recovery in the hospital. A liquid diet starts almost immediately after the surgery, with a gradual transition to solid foods.

Be aware that this type of weight loss surgery can increase the risk of gallstones. Your bariatric physician may also recommend that you have surgery to remove your gallbladder before your gastric bypass surgery.

Be sure to consider all your options and educate yourself thoroughly before making the decision to have bariatric gastric bypass. It is major surgery, it is expensive, and it requires a commitment to major dietary and lifestyle changes in order to be successful over the long-term.

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For obese individuals who have decided to undergo weight loss surgery, a new technique known as laparoscopic bariatric surgery is now available.

This minimally invasive laparoscopic bariatric surgical procedure involves a bypass of a portion of the stomach. Options include laparoscopic isolated gastric bypass, adjustable gastric band, Roux-en-Y and sleeve gastrectomy.

Using a laparoscope, four to six small openings approximately one-half to one inch long are made in the patient’s abdomen. These openings allow the bariatric surgeon to pass a light, a camera, and some surgical instruments into the abdomen.

Next, the abdomen is inflated with carbon dioxide gas in order to allow the surgeon to get a better view of the inside of the stomach and its internal structures. Surgical instruments about the size of a pencil are then placed into the abdomen to perform the surgery.

In a Roux-en-Y gastric bypass, more than 95 percent of the stomach is bypassed and only a small portion remains functional. A  related bariatric procedure known as a sleeve gastrectomy involves the removal of roughly 70% of the stomach by bypassing the intestines.

Adjustable Gastric Band Procedure

In an adjustable gastric band procedure, the stomach is restricted by the placement of the gastric band, which can be adjusted after surgery for further weight loss.

A gastric band device is inserted through very small incisions in the abdomen and then placed around the upper part of the stomach. The resulting pouch (sometimes called the “new stomach”) dramatically reduces the digestive capacity of the stomach.

The band has a balloon on the inside that is adjustable in order to reduce stoma size. This prolongs the period of fullness, and reduces food consumption.

This weight loss surgery is performed under general anesthesia and takes from 30 minutes to an hour to complete. The band is fitted around the uppermost section of the stomach, forming a very small pouch.

The pouch is designed so that it can be inflated or deflated at any time after the operation. With the support of a bariatric surgery diet, this helps the patient continue to lose weight until their weight-loss goals are achieved.

Minimally invasive bariatric surgery has been performed since the mid-1990′s. The overall results after laparoscopic weight loss surgery appear to be equal to open bariatric procedures.

Laparoscopic Bariatric Surgery Candidates

Not all patients are suitable for laparoscopic weight reduction surgery, so an open bariatric weight loss procedure is sometimes necessary.

These days, almost all bariatric operations can be performed using laparoscopic techniques. Currently, bariatric surgical procedures are the most effective way to achieve significant, sustained weight loss for the morbidly obese.

The treatment of obesity through surgery is often more successful than fad diets, meal supplements and shape-up-in-a-hurry exercise programs. Acupuncture to lose weight may or may not be effective in cases of morbid obesity, but is certainly worth trying.

When performed by properly trained surgeons, bariatric surgery performed via laparoscope appears to speed recovery and helps patients return to a normal, productive life sooner than with open surgical procedures.

Nevertheless, when considering weight loss surgery, be sure to research the background and qualifications of your bariatric doctor thoroughly. It is not a decision to be taken lightly.

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There are a multiple types of bariatric procedures available for weight loss. One general type is known as restrictive bariatric surgery. This procedure reduces the size of your stomach but does not change your digestive process.

Another category is called malabsorption or malabsorptive procedures. This type of weight loss surgery shrinks the stomach and also bypass the duodenum and sometimes the jejunum. The resulting “malabsorption” means fewer calories are taken in by your body. Fewer calories absorbed = greater weight loss.

Restrictive Bariatric Surgery

Restrictive bariatric surgeries include Adjustable Gastric Banding (AGB) and Vertical Banded Gastroplasty (VBG). These procedures do not alter your digestive system; however they do reduce the amount of food you can ingest. After the surgery, a person can only eat about one cup of food at a sitting.

If you eat more than the recommended amount you will probably throw up and might also stretch your new stomach, causing the surgery to fail. Vertical Banded Gastroplasty is also known as stomach staple surgery.

Adjustable Gastric Banding is familiar to many as the Lap Band. The advantages of the lap banding are fewer complications than other bariatric procedures. The drawbacks to this procedure are slower weight loss and also the fact that you cannot have other health complications present in order to be approved for lap-banding. But the process is less invasive than other surgeries, and the lap band can be removed later if the patient so chooses.

Malabsorptive Bariatric Surgery

Malabsorptive bariatric procedures work by reducing the size of the stomach and effectively bypassing the duodenum and sometimes also the jejunum. Malabsorption weight loss surgery includes Roux-en-Y, commonly called gastric bypass surgery, the Duodenal Switch, the Fobi Pouch, and Biliopancreatic Diversion.

In the Duodenal Switch procedure, the surgeon blocks off part of the stomach, making it smaller. This reduces the amount of food that can be ingested and also limits calorie absorption. However, within a few months, a patient can resume eating the same food as they did before (with certain limitations, of course).

New Bariatric Procedures

The latest bariatric procedures are focused on minimally-invasive techniques. Laparoscopic bariatric surgery was the first of these newer techniques, and the past couple of years have seen the introduction of an improved technique in which endoscopic surgical instruments are inserted through the patient’s mouth.

Known as StomaphyX™, a hose-like surgical device is inserted through the mouth, allowing the bariatric surgeon to grasp the stomach tissue and employ suture anchors. The physician creates several tissue folds in the stomach wall, thereby reducing its capacity to hold food. In most cases, the StomaphyX procedure can be performed as outpatient surgery.

Does Insurance Cover Bariatric Surgery?

Medicare currently reimburses for bariatric procedures on a regional basis and is the primary payer for approximately 20% of all procedures performed. There are procedure reimbursement codes for bariatric surgery with prior authorization.

However, some weight loss surgeries are considered cosmetic and likely won’t be covered by your insurance. Be sure to research and thoroughly understand the insurance issues involved before going ahead with any type of bariatric surgery for weight loss.

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For extremely overweight or morbidly obese individuals who have made many unsuccessful attempts at losing weight, stomach staple surgery may be one of their few remaining weight loss solutions. This is a major operation, during which a bariatric surgeon creates a small pouch at the top of the stomach where it meets the esophagus. The procedure is done through the use of staples and a band that is filled with saline which can expand and contract.

The success of weight loss surgery often depends on the willingness of the patient to change his or her eating and exercise habits. There are also significant side effects and risks associated with this surgery, which means that it should only be done after serious consideration of all the potential risks and rewards.

Vertical banded gastroplasty (VBG)

In bariatric medicine, stomach stapling – also known as gastric stapling or gastroplasty – is a surgical technique which uses gastric staples to reduce the size of the stomach, creating a “new” stomach pouch. The pouch will typically be big enough to hold one to three ounces of food at a time.

At the lower end of this “new” stomach, an opening of about two centimeters is created. This slows down the passage of food, allowing the individual to feel full sooner. As a result, the individual can only eat just a small quantity of food at a time.

Sometimes stomach staple surgery is done in conjunction with another procedure called a malabsorptive operation, in which food from the stomach is diverted past much of the small intestine. This dramatically limits the ability of the body to absorb calories and nutrients from the food, resulting in quick weight loss.

After Stomach Staple Surgery

After stomach staple surgery, a patient will be forced to change daily eating patterns. It will be necessary to eat food in smaller amounts and to chew thoroughly.

The patient will not be able to eat foods high in sugar or fat, because these foods empty from the stomach more quickly than foods high in protein or complex carbohydrates such as fiber, and thus can cause uncomfortable side effects. This is known as “dumping syndrome,” where food passes through the new stomach opening too rapidly, causing weakness, nausea, dizziness and vomiting.

The patient will also need to take nutritional supplements for the rest of his or her life, because there will not be enough nutrition in the reduced portions of food. Regular physical activity will also be required, despite it not having been a part of the patient’s life prior to the surgery.

Stomach Staple Surgery Cost

How much does stomach staple surgery cost? The price for bariatric stomach stapling averages between $20,000 and $30,000. Stomach stapling is considered major weight loss surgery. To be accepted for bariatric surgery, an individual needs to have a body mass index (BMI) of over 40.

For males, this means being at least 100 pounds overweight for their height. Females must be at least 80 pounds over the healthy weight range for their height. Health insurance may or may not cover the operation, depending on the particular insurance plan.

Does Stomach Staple Surgery work?

Complete weight loss takes anywhere from 12 to 24 months after stomach staple surgery is performed. But long-term success of weight loss surgery ultimately depends on the individual’s motivation to change his or her lifestyle.

Eating and exercise habits must be modified significantly, or there is a chance the weight will come back.

Is Stomach Staple Surgery dangerous?

Between ten and twenty percent of people who undergo the surgery will need to have at least one follow-up procedure due to complications. The band can slip, or sometimes break, releasing saline into the abdomen. The staples may deteriorate and need to be replaced.

In a small number of cases, digestive juices from the stomach can leak  into the abdomen, requiring immediate emergency surgery. In less than one percent of stomach staple surgery cases, infection can lead to death.

Clearly, the risks and rewards of this type of weight loss surgery should be considered very carefully through consultation with a bariatric physician experienced in bariatric gastric bypass before deciding to go ahead.

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