January 10th, 2018
Gastric bypasses – benefits and challenges
Gastric bypasses are surgical procedures done on an individual to make the stomach smaller. There are three types of gastric bypasses; Roux en-Y (distal), Roux en-Y (proximal), and Loop Gastric bypass (Rogers 2). Gastric bypass is indicated for treatment of morbid obesity; prognosis is made when the patient is critically obese, a status indicated by a body mass index greater than 40(Rogers 3). Particularly, such a procedure may be necessitated where the obese individual is incapable of achieving sustained and satisfactory loss of weight by dietary methods, and is ailing from co-morbid conditions, which are either, grave or cause severe impairment of the quality of life. It is also applied in the treatment of sleep apnea, type II diabetes and hypertension (Rogers 5-7). It is one of the most effective methods of weight loss and control. The reduction in the size of the stomach makes one feel full more rapidly; this cuts down on the amount of food consumed and thus the calories ingested. Besides, the circumventing of a part of intestines also lessens the amount of calories absorbed; these results in weight loss (Rogers 15). The increasing interest in the topic is due to the gradual increase of morbidity arising from obesity cases, among the Americans. There has been an increasing demand for the gastric bypass surgeries with over 200,000 individuals estimated to be undergoing this procedure annually (Georgianna 77). The main focus of this paper is to review information on gastric bypasses, and highlighting how the information impacts on my original views and thoughts on the subject.
The procedure carried out during gastric bypass surgery has been described in various literature. Firstly, a small thumb-sized pouch of approximately 5-30 milliliters is made from the upper stomach, and then the remaining stomach is circumvented, usually, for at least 400 milliliters (Woodward 21). Following this procedure, an individuals consumption of food at any particular moment is greatly reduced. Basically, the stomach is divided using surgical staples or it can be fully partitioned into two pouches with staplers and placement of a marlex band – a polypropylene mesh (Woodward 22). Total partition is usually preferred, to avoid the risk that the two pouches of the stomach will fistulize back together, negating the operation. The gastrointestinal tract is then re-constructed to allow drainage of both pouches of the stomach (Woodward 22). The reconstruction technique varies and it determines the degree of food absorption, the rate of emptying food from the stomach and in general the name given to the procedure (Woodward 22). The reconstruction technique also largely determines the postoperative risk of occurrences of nutritional deficiencies and the various complications associated with gastric bypasses.
Gastric bypass surgery is currently the most potent method to treat obesity. In the majority of individuals, it produces considerable weight loss that is well sustained and linked to significant improvements in mortality, physical and psychological co-morbidities. Research findings indicate that significant weight loss is always achieved with two-thirds of the excess weight being a reasonable expectation (Woodward 12). Additionally, gastric bypass has facilitated a reduction of at least half of the excess weight in 80 per cent of those having the surgery (Woodward 12). It has also been widely performed on individuals particularly amongst celebrities for cosmetic purposes to help reduce weight and attain a slim figure so coveted by current society. To determine if one is a candidate for gastric bypass surgery, the body mass index (BMI) is calculated, and the physician makes the decision based on the index. In general, gastric bypasses are considered for people with BMI of 35- 39.5, if they have obesity-related illnesses and those with BMI greater than 40 with or without related illnesses (Woodward 13-14). Gastric bypass surgery may boost the chances of living longer. Studies have confirmed that individuals who have undergone the procedure have a lower likelihood of dying of diabetes, heart diseases, or cancer (Woodward 13). Go to part 2.