Laparoscopic mini-gastric bypass, sleeve gastric bypass
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Reasons for Procedure
- Body mass index (BMI) greater than 40
- BMI greater than 35 with cardiovascular disease, sleep apnea or uncontrolled type 2 diabetes
- BMI greater than 35 with severe physical limitations that affect employment, mobility, and family life
- Long-term weight loss
- Improvement in many obesity-related conditions, such as diabetes, sleep apnea, high blood pressure, and high cholesterol
- Improved mobility and increased energy
- Improved mood, self-esteem, and quality of life
- Reduced risk of dying from cardiovascular disease
- Adverse reaction to anesthesia, especially in patients who also have sleep apnea
- Blood clot formation in the veins of the legs or lungs
- Excess bleeding
- Leaking of stomach contents into the abdominal cavity
- Hernia formation
- Death (rare)
- Dyspepsia or ulcers
- Scar tissue formation creating a bowel obstruction
- Low blood sugar called hypoglycemia
- Nutritional deficiencies particularly low levels of protein or vitamins
- Body image distortion—patients have difficulty adjusting to their new appearance
- Inability to lose weight after surgery
- Excess weight loss (rare)
- Recent or chronic illness, such as kidney disease
- Increased age
- Heart or lung disease
- Bleeding or clotting disorders
What to Expect
Prior to Procedure
- A physical exam and review of your medical history
- Attempts to lose weight through medically approved dietary means
- Ongoing consultations with a registered dietician
- Mental health evaluation and counseling
Talk to your doctor about your medicines, herbs, and dietary supplements. You may be asked to stop taking some medicines up to one week before the procedure. These may include:
- Anti-inflammatory drugs
- Blood thinners
- Anti-platelet drugs
- Do not start taking any new medicines, herbs, or supplements without talking to your doctor.
- Arrange for a ride to and from the hospital.
- Arrange for help at home as you recover.
- You may be asked to take laxatives or give yourself an enema to clear your intestines.
- The night before your surgery, eat a light meal. Do not eat or drink anything after midnight unless told otherwise by your doctor.
- Shower or bathe the morning of your surgery.
Description of the Procedure
Immediately After Procedure
How Long Will it Take?
How Much Will it Hurt?
Average Hospital Stay
- Pain medicine will be given as needed.
- On the day after surgery—you will have an x-ray to check for leaks from the stomach.
- Use an incentive spirometer to help you take deep breaths. This helps prevent lung problems.
- Wear elastic surgical stockings or boots to promote blood flow in your legs.
- Get up and walk in the hall daily.
- You will begin with 4-6 meals per day. A meal is two ounces of food. For the first 4-6 weeks after surgery, all food must be pureed.
- Once you move to solid foods, you will need to consume enough protein. Follow your dietitian’s meal plans.
- Avoid sweets and fatty foods.
- Eating too much or too quickly can cause vomiting or intense pain under your breastbone. Most people quickly learn how much food they can eat.
If you are taking medications or supplements:
- Crush any non-chewable pills
- Opt for chewable pills or liquid when possible
Call Your Doctor
- Signs of infection, including fever and chills
- Redness, swelling, increasing pain, excessive bleeding, or discharge from the incision site
- Cough, shortness of breath, chest pain, or severe nausea or vomiting
- Worsening abdominal pain
- Blood in the stool
- Pain, burning, urgency or frequency of urination, or persistent bleeding in the urine
- Persistent nausea and/or vomiting
- Pain and/or swelling in your feet, calves, or legs
- Sudden shortness of breath or chest pain
- Any other worrisome symptoms
American Society for Metabolic and Bariatric Surgery http://asmbs.org
Weight Control Information Network http://www.win.niddk.nih.gov
BC HealthLink http://www.healthlinkbc.ca
Canadian Laparoscopic Weight Loss Surgery http://www.weightlosssurgery.ca
Bariatric surgery. EBSCO DynaMed website. Available at: https://dynamed.ebscohost.com/about/about-us. Updated January 12, 2013. Accessed January 15, 2013.
Bariatric surgery: day of surgery and hospital stay. West Penn Allegheny Healthy System website. Available at: http://www.wpahs.org/specialties/bariatric-surgery/day-surgery-and-hospital-stay. Accessed January 15, 2013.
Bariatric surgery Risks and Complications. West Penn Allegheny Healthy System website. Available at: http://www.wpahs.org/specialties/bariatric-surgery/risks-and-complications-bariatric-surgery. Accessed January 15, 2013.
Gastrointestinal surgery for severe obesity. National Institute of Diabetes and Digestive and Kidney Diseases website. Available at: http://win.niddk.nih.gov/publications/gastric.htm. Accessed January 15, 2013.
Laparoscopic weight loss surgery. Cleveland Clinic website. Available at: http://my.clevelandclinic.org/services/laparoscopic%5Fsurgery/hic%5FLaparoscopic%5FWeight%5FLoss%5FSurgery.aspx. Accessed January 15, 2013.
Maciejewski ML, Livingston EH, Smith VA, et al. Survival among high-risk patients after bariatric surgery. JAMA . 2011;305(23):2419-2426.
Mini-gastric bypass. Sutter Pacific Medical Foundation website. Available at: http://www.sutterpacific.org/bariatrics/weightloss/mini-gastric-bypass.html. Accessed January 15, 2013.
Rationale for the surgical treatment of morbid obesity. American Society for Bariatric Surgery website. Available at: http://asmbs.org/rationale-for-surgical-treatment. Accessed January 15, 2013.
Weight loss surgery. Boston Medical Center website. Available at: http://www.bmc.org/weight-loss-surgery/choosingsurgery/surgeryoptions.htm#Gastric%5FBypass. Accessed January 15, 2013.