The Gastric Bypass Procedure Gastric bypass, so named because it reroutes part of the small
intestine around much of the stomach, is done through a long incision
down the abdomen or sometimes through a small puncture with a scope.
The upper stomach is closed off with staples, reducing the functioning
stomach from the size of a football to a shot glass. The small
intestine is cut from below the original stomach and reconnected to
the upper pouch.
Pounds melt off for most patients because the new, tiny stomach fills
with just a few bites, and because food travels a shorter digestive
route - skipping the lower stomach and upper small intestine - so less
of it is digested and absorbed by the body.
Other weight-loss surgeries involve constricting the stomach with an
adjustable silicone band or bypassing most of the small intestine. But
gastric bypass surgery, considered the gold standard, is the most
popular form of obesity surgery.
The National Institutes of Health has embraced the operation as the
only consistently effective method of weight loss for people who are
morbidly obese, or at least 100 pounds overweight.
Yet the American Society for Bariatric Surgery estimates one in 200
patients dies from the surgery. Dr. E. Patchen Dellinger, chief of
general surgery at the University of Washington Medical Center, says
he surveyed Washington surgeons and found the risk to be about double
that, or one in 100.
Either way, the rate is significantly higher than that for most
Restrictive operations serve only to restrict food intake and do not
interfere with the normal digestive process. To perform the surgery,
doctors create a small pouch at the top of the stomach where food
enters from the esophagus. Initially, the pouch holds about 1 ounce of
food and later expands to 2-3 ounces. The lower outlet of the pouch
usually has a diameter of only about ¾ inch. This small outlet delays
the emptying of food from the pouch and causes a feeling of fullness.
As a result of this surgery, most...