Gastric bypass Perth
Cindy had gastric bypass surgery and lost 46kg in 12 months.
Expected excess weight loss:70 - 80 %
Average procedure time:120 minutes
Average recovery time:3 weeks
Gastric bypass(for weight loss)
Of all bariatric surgeries available, gastric bypass is probably the most well known. This is because, in its original form, it has been around the longest. It is a serious operation with certain side effects that must be considered carefully.
The newer version of the surgery is even more effective, and both bypasses are especially good as a revision surgery after a previous weight loss surgery.
What is a gastric bypass?
Gastric Bypass is the oldest form of weight loss surgery. It was originally performed as an open procedure, however, since the 1980’s it has been done laparoscopically (keyhole).
A Laparoscopic Gastric Bypass combines several elements to achieve weight loss. There are many different types of bypasses, but essentially, they can be divided into two separate types. The others are minor variations on these two themes.
Video: Gastric bypass | Perth bariatric surgeons
The common features across all of the surgeries
A small pouch, which in our Perth practice looks a little like a mini sleeve. The pouch is equivalent to the sleeve in diameter (12mm) but is only 7-12cm long. This is much shorter when compared to a sleeve, which is usually 15-20 cm long. Some surgeons make pouches that are shorter but wider, but we (and most Australian surgeons) prefer the longer, thinner pouch for technical reasons.
An important element of the bypass is where food is bypassed away from the first part of the small bowel, duodenum, and jejunum. This has a major impact on gut hormones that are released by the presence of food in these parts of the bowel. These hormones seem to reset the “set point” in your brain to a lower weight. The different bypass methods all vary in how much bowel is bypassed. Finding the exact right amount is difficult. Bypass too little and there is a compromise on weight loss. Bypass too much and it will cause diarrhoea and malabsorption of nutrients.
Types of gastric bypass
The Roux-En-Y Gastric Bypass (RNY Gastric bypass)
The Roux-en-Y bypass has been around for the last forty years and is considered the gold standard for weight loss operations. Most of us feel that this “gold standard” label is for historical reasons, and it’s very hard to change the general perception.
The Omega Loop Gastric bypass or Mini Gastric Bypass
The Omega Loop Gastric bypass or Mini Gastric Bypass has been described in different forms over the last 30 years, but only in recent times has it become a true entity. It provides better weight loss than the RNY Gastric Bypass, but is not as good for the control of reflux symptoms that frequently occurs following bariatric surgery. An Omega Loop bypass can, however, be converted to a RNY Gastric Bypass if reflux is an issue.
Complications after gastric bypass
Gastric bypasses are not a benign procedure, with risks to consider alongside the advantages. We encourage everyone to seriously consider the benefits of a sleeve gastrectomy when possible.
This is because there are gastric bypass side-effects that may have a serious impact on the quality of life.
Benefits of gastric bypass surgery?
Bypass surgery is a great revision procedure. It’s effective for managing reflux and has a proven track record. Over a million procedures have been done around the world, and we understand the RNY Gastric Bypass really well.
The newer Omega Loop Gastric bypasses are performing even better in terms of expected weight loss, and are emerging as a simpler operation to perform.
The concern is that, especially in young people, a lifetime of malabsorption will have serious detrimental effects on their long term health outcomes. There is also a concern that if the bypass starts to fail post-surgery, then we are very limited in terms of options for further revision procedures. We can talk to you about why bariatric operations fail, or lose their effectiveness over time.
Gastric Bypasses, like a sleeve gastrectomy, can leak. However, these leaks do tend to be less severe and get better with time reasonably quickly. Dumping and diarrhoea are also common complications following gastric bypass surgery. There is more information on dumping syndrome available.
Why vitamin supplements are so important
When you have a gastric bypass, you will not be able to get your vitamins and protein in with food alone. You need the supplements because you are not eating that much and this may lead to vitamin deficiency. It is really important that you take your vitamins every day (protein supplements and a multivitamin) and it's important that you have your levels measured at least every year.
So which vitamins are important:
- B1: important for your brain function
- B6: for peripheral nerves
- B12: for spinal cord
- Iron: when your iron levels are too low you will feel very tired
- Minerals are important
- Calcium is very important, in later years you may get osteoporosis
The problem with bypasses is, because of that malabsorption, you don't tend to absorb all the vitamins that you eat. That's why we want to see you at least once a year to check your blood and vitamin levels.
About Obesity Surgery WA: Our 6 commitments
Taking surgery seriouslyWe know that entering into an operation is a big deal and we are very serious in getting the best outcome for you. We practice what is considered to be a world class standard. Our staff regularly attend national and international conferences and bring back what is the latest research and technology.
Running on timeOur Surgeons and all of our staff try their best to run on time. Although it's not always possible, our commitment is that we do our best. Your time is valuable and we respect that.
Readily availableOur surgeons (or at least one of them) are always available in a crisis. Some of them may provide you with a direct contact, but all are available through the hospital switchboard and happy to chat any time if there is a crisis.
An obsessive attention to detailWe do our best to not miss anything. Every stitch, every staple and every clip is applied to exactly where it needs to be with the greatest care possible.
Commitment to performing the best operation possibleNot all operations are the same and there a few extras that we do to make things better. We know that our results are better with the minimiser ring so we offer it to everyone. We know that reflux can be an issue so we try to tighten every oesophageal hiatus to make reflux control as good as possibly can be.
A commitment to new technologies
- We have brought in STRETTA into Western Australia, which we believe will revolutionise reflux management. (Have a look at the Stretta page for more information).
- SJOG Murdoch has just purchased a new DaVinci robot and we believe that this will allow us to do operations with keyhole surgery that previously needed a major laparotomy incision. Lynx is on the horizon and promises to also help manage reflux, we hope to have access to this in early 2020.
Meet our team
Dr. Harsha Chandraratna
Dr. Bill Gong
General and Laparoscopic Surgeon