04 Feb The Gastric Bypass–The Gold Standard
Why Bypass is Best
In continuing our review of obesity and effective treatments, it’s time to provide an update on the safety and effectiveness of the different surgical options that bariatric surgery has to offer.
The Roux-en-Y gastric bypass is considered by many to be the gold standard for weight-loss surgery. It was first done in the late 1960’s as an open procedure. Twenty years ago the laparoscopic method was developed making the recovery period significantly easier. The procedure has two basic parts: a small pouch in the upper stomach and a bypass of the first part of the small intestine. The small pouch is designed to hold only about 1 to 1.5 ounces as it will stretch out to about 25-30% of a normal size stomach at 1 year. This represents the restrictive part of the operation and the component that will make you feel full and not hungry. The second part of the operation is the bypass of the first part of the intestine–usually about 40-45 inches. This component shortens the absorption portion of the intestines which leads to ultimate weight loss. With the combination of both components of the operation, the restrictive and the absorptive, the average person will lose 70% of their excess weight at about 1 year. The long-term weight loss at approximately 5 years is expected to be about 60-65% of excess weight loss.
The other major advantage of the bypass has to do with the resolution or improvement in obesity-related co-morbidities. After having a gastric bypass, type II diabetes goes into remission 80-85% of the time. This means no medications with normal blood glucose levels. This phenomenon usually occurs by the time of discharge from the hospital. In addition, other common and problematic co-morbidities such as high blood pressure and obstructive sleep apnea also resolve about 60% of the time with improvement seen in the remaining patients.
The gastric bypass procedure is done with a scope–laparoscopy–and should be done only in an inpatient facility and most preferably one that is a designated Center of Excellence. Studies have shown better results when it is done as an inpatient where complications can be quickly diagnosed and treated effectively. Major complications are infrequent with leaks occurring less than 0.3% and blood clots occurring in less than 1%. The mortality rate is the same as having an appendectomy or having your gallbladder removed so it is very low.
In summary, the Roux-en-Y gastric bypass is an excellent surgical procedure for weight loss. It has the added advantage of resolving or improving most major co-morbidities–particularly, type II diabetes which can be very difficult to treat on its own. It is a safe operation when done at a Center of Excellence by an experienced surgeon in an inpatient facility.
Please call our office at 303-861-4505 if you are interested in weight-loss surgery or visit our website. We are here to assist you in achieving your weight loss goals and a healthier and happier lifestyle.
Dr. Tom Brown
Colorado Bariatric Surgery Institute