The size of your stomach will vary depending on the surgeon. All surgeons use a tube to guide them when stapling the stomach. This tube size can vary from as small as 32 French Bougie (1-2 ounces) to as large as 64 French Bougie (6-8 ounces). This is a very important question to ask when considering this surgery, since those patients with larger pouches may have less weight loss.
This type of stomach removal has been performed with the Duodenal Switch procedure since the mid 1980’s. It does involve stapling, just like in the gastric bypass and has similar risks. Interestingly, patients do not ever return asking for their stomach back but many do wonder if it is possible to reduce the size of it again.
Vitamin deficiencies are rare with this procedure because there is no intestinal bypass. However, the procedure is very restrictive so most surgeons recommend that patients take a multivitamin, calcium and possibly a B12 vitamin after surgery.
All patients undergoing weight loss surgery are at risk for weight regain. None of the operations can prevent this. Those patients who maintain good dietary habits and exercise patterns are more likely to keep the weight off than those who do not exercise and who snack frequently.
The diet will progress over the first year. It usually starts with 2-4 weeks of liquid protein drinks and water. Patients gradually progress to thicker food items and by two months are able to eat seafood, eggs, cheese and other regular foods. The diet generally recommended is low calorie (500 per day), high protein (70gm per day), low fat (30 gm per day) and low carbohydrates (40 gm per day).
The calorie intake increases over the first year and by 12 months many patients have achieved their goal weight and consume between 900 and 1500 calories per day. This final calorie intake depends on level of activity, age and gender(men can usually consume more calories and maintain their weight).
Keep in mind that gastric bypass isn’t for someone who just wants to shed a few pounds. It’s for people who are more than 100 pounds overweight, or who have a higher BMI than 40, which qualifies as morbidly obese.
It’s the reduction of your portion sizes and the lessened calorie absorption that leads to weight loss, not the procedure in and of itself. Thanks to your much smaller stomach, you must eat restricted portions following gastric bypass. However, you will not feel hungry after eating those small portions like you would with your stomach the size it is now. Plus, the calories contained in the foods that you eat aren't absorbed as well by your system due to the intestinal bypass, further reducing total calories taken in.
To keep the weight off, those lifestyle changes your doctor prescribes will need to be permanent. Al Roker, for example, has given up his favorite McDonald's meals and exercises regularly. Gastric bypass works, but you have to work at it!
As with any surgery, there are risks such as bleeding, infection, or an adverse reaction to anesthesia. Other risks include, anastomotic leakage, deep venous thrombosis, pulmonary embolism, follow-up operations to correct complications, increased risk for gallstones and nutritional deficiencies such as anemia. Your surgeon will inform you of the risks prior to surgery.
The largest amount of weight loss occurs in the first 6 months. Most people continue to lose weight slowly for the following twelve to eighteen months. The weight loss typically plateaus at two years and some people will regain a small portion.
After your operation you will be monitored in the recovery room for a period which varies between 2-4 hours. Most of our Gastric Bypass patients will be monitored in the Intensive Care unit overnight. A typical hospital stay after the surgery is 2 to 3 days and overnight in the ICU on the first night after surgery.
The price of the surgery depends on the hospital and the part of the country that you are in. Please contact us to learn more and to find out if your insurance will cover your weight-loss surgery.