Gastric bypass is restriction surgery with a hypoabsorptive component. The surgeon will make a small gastric pouch and then attach part of the small intestine to it. The small stomach pouch will cause faster satiety (feeling full faster), so there will be a decreased ability to ingest food.
This intervention is based on two principles: reducing the size of the stomach and reducing the assimilation of food by the body due to a short-circuit of part of the intestine.
Gastric restriction decreases the amount of food ingested and satiety appears more quickly. For its part, malabsorption leads to a reduction in the quantity of food that is assimilated.
It is performed under general anesthesia, minimally invasive with the assistance of a surgical robot or by laparoscopy. A camera is inserted through a small hole in the abdominal wall and working instruments are inserted through five other small holes (see procedure illustration).
The size of the stomach is reduced per section and only a small gastric pouch with a volume of 20-30 ml is retained. The intestine is then cut and connected to the gastric pouch. Part of the intestine is thus short-circuited over 75 cm.
At the end of the operation, the incisions are closed with absorbable suture (which disappears on its own). The dressing is carried out with glue, which also removes itself.
Since food does not mix with bile and pancreatic enzymes in the first 150 cm of the small intestine, calorie absorption is reduced.
They are generally rare and can occur early or late.
In the days following the intervention:
- Rupture of internal sutures (intestinal or stomach): this occurs very rarely (less than 0.2% of cases) and is especially favored by smoking and diabetes.
A reoperation may be necessary as well as antibiotic treatment or the installation of a drain.
- There is also a risk of approximately 1% for each of the following complications: haemorrhage, intestinal obstruction, abscess, pulmonary embolism.
After 30 days:
- Internal hernia, the frequency of which can reach 3% of cases, requires urgent reoperation.
CAUTION:If you have intense, sudden and continuous pain lasting more than an hour, consult an emergency service immediately. It could be an internal hernia.
- The "dumping syndrome" is manifested by great weakness and sweating. This is most often hypoglycemia due to excess insulin secondary to weight loss. Frequent snacking and a diet low in sugar and high in protein can prevent it.
- Un ulcère ou un rétrécissement du raccordement entre l’estomac et l’intestin, d’où l’importance de maintenir l’arrêt du tabac à vie après l’opération.
- Vitamin deficiencies that can be filled by a more suitable dosage of the prescribed supplements.