Gastric bypass surgery (most commonly the Roux-en-Y gastric bypass) is a weight loss procedure that works by making your stomach smaller and by bypassing part of your digestive system. This means that you won't be able to eat as much and your body will absorb less of the food you do eat. The procedure is performed as keyhole surgery. You will be under general anaesthesia so that you sleep through the operation. It generally takes between one and three hours.
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Gastric bypass surgery is a very safe procedure. However, your doctor will explain the risks in detail so that you can provide informed consent. It is important to understand the potential adverse effects and complications, even if the chance of experiencing these problems is small.
Sometimes the operation can produce unwanted side-effects alongside the beneficial effects of the surgery. These side-effects are usually temporary. The most common side-effects of gastric bypass surgery are swelling, bruising and pain around the surgical wound. You may also feel a bit sick or vomit after your meals as you get used to the change in your stomach size. You can reduce the risk of this by limiting the amount you eat. If you eat too many sugary foods you can get an unpleasant sensation, called "dumping", which may make you feel sick or faint, or give you diarrhoea. You should drink plenty of fluids until the feelings have passed, and you should also reduce the amount of sugary foods you eat. Some of the side effects can last longer. One of the effects of gastric bypass surgery is that it will be harder for your body to absorb nutrients. This, along with your more restricted diet, could put you at risk of deficiencies in certain vitamins and minerals, particularly calcium and iron. You might need nutritional supplements to stay healthy.
Complications are problems that occur either when you are in surgery or soon afterwards. Serious complications are rare after gastric bypass surgery, but they do affect some patients.
Like any serious operation requiring general anaesthesia, the gastric bypass procedure comes with a risk of certain complications. You might experience a bad response to the drugs and anaesthetic, you might lose more blood than expected, or you could develop blood clots that might cause problems such as a pulmonary embolism or DVT. The risks of having surgery will be higher if you have any medical problems such as cardiovascular disease.
Among the complications that can develop after gastric bypass surgery are:
Infection – can often be treated or prevented with antibiotics.
Damage to abdominal organs – may require surgical repair.
Anastomotic leak (join) - the point where your intestine is re-joined to your stomach pouch could start leaking in the days after surgery. Another operation might be needed to fix the problem.
Anastomotic stricture or anastomotic ulceration (join) – the point where your intestine is re-joined to your stomach pouch could become too narrow. Ulcers could also develop after surgery. You might need to have an endoscopy to repair it, or another operation.
Internal herniation and adhesion problems – you may need further surgery for it.
Gallstones – rapid weight loss can sometimes cause gallstones to form. Gallstones can be very painful and sometimes need to be removed surgically.
Failing to reach your target weight – some people do not lose enough weight after the procedure. Some people lose weight but then regain it later.
If a problem does arise during the operation, it may not be possible to complete the procedure laparoscopically. The surgeon will need to create a larger incision to perform open surgery. However, this will only be done if it is absolutely necessary.
The precise risks of a gastric bypass are different for everyone. However, the overall risk of complications is usually about 2-5%. The risk of a fatal complication is much smaller, at 0.5%.
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