Since 1991, major developments in the field of bariatric surgery, particularly laparoscopy, have updated some of the conclusions of the NIH panel. In 2004, a consensus conference was sponsored by the American Society for Bariatric Surgery (ASBS), which updated the evidence and the conclusions of the NIH panel. This conference, composed of physicians and scientists of both surgical and non-surgical disciplines, reached several conclusions, amongst which were:
- Bariatric surgery is the most effective treatment for morbid obesity.
- Gastric bypass is one of four types of operations for morbid obesity.
- Laparoscopic surgery is equally effective and as safe as open surgery.
- Patients should undergo comprehensive preoperative evaluation have multi-disciplinary support for optimum outcome.
- Various laparoscopic (minimally invasive) surgical procedures have evolved in an effort to “shunt” or bypass a portion of the stomach. Four to six small openings (each less than one-half to one inch long) are made in the abdomen (Laparoscopic Surgery). These openings allow the surgeon to pass a light, camera, and surgical instruments into the abdomen.
- Surgical instruments about the width of 5mm are placed into the abdomen to complete the surgery.
- In a Roux-en-Y gastric bypass, greater than 95 percent of the stomach is “bypassed” and a small portion (the size of an egg) remains functional. The remaining of the stomach pouch is then connected to the intestine. The remaining of the intestines are also bypassed so that only a small portion of intestine is available for absorption.
Most patients recover from surgery with no complications.
- The hospital stay is usually 3 to 5 days.
- You may be off work for 2 to 4 weeks.
- Once at home, you will need to follow specific eating guidelines. Your dieticians will assist you in understanding and adjusting to these guidelines.
- Regular follow-up visits are scheduled during the first year after surgery to check your overall physical and mental health, metabolism and nutritional status.
- Many patients will need plastic surgery (abdominoplasty) 1 to 2 years after weight loss to remove skin folds around the abdomen.