Most patients stay 1 - 2 nights in the hospital after gastric bypass. The morning after surgery you will undergo an Upper GI Series where you drink water soluble contrast to prove all the connections (anastomoses) look perfect, after which if you are drinking enough liquids and your pain is controlled with PO (oral) pain medications you can be discharged home.

The Gastric Bypass works in several ways. Like many bariatric procedures, the newly created stomach pouch is smaller (about the size of an egg, ~1 oz/30cc) and can accommodate less food, which means fewer calories are ingested. Furthermore, food does not come into contact with the first portion of the small bowel (the duodenum and first portion of the jejunum), this results in decreased absorption. However, the most important mechanism is going around or “bypassing” the duodenum, this modification of the food course through the gastrointestinal tract has a profound effect to decrease hunger, increase fullness, and allow the body to reach and maintain a healthy weight. The impact on hormones (including Ghrelin, the hunger hormone) and metabolic health most often results in improvement of adult onset diabetes even before any weight loss occurs. There is typically improvement in insulin sensitivity and decrease in insulin resistance the first week! We can stop the use of insulin almost immediately postoperatively on the vast majority of patients! The operation also resolves reflux (heart burn) in most patients.
Along with making appropriate food choices, patients must avoid tobacco products and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen and naproxen.

Data from almost 60,000 bariatric patients from American Society for Metabolic and Bariatric Surgery (ASMBS) Bariatric Centers of Excellence database show that the risk of death within the 30 days following bariatric surgery averages 0.13%, or approximately one out of 1,000 patients. This is considerably less than most other commonly performed operations, including gallbladder (0.7%) and hip replacement surgery (0.93%). The data shows that the chance of dying from bariatric surgery is exceptionally low and it is safer than gallbladder and hip replacement surgery.

In terms of results, most patients lose between 70-85% of their Excess Weight (EW), and the vast majority have resolution of their obesity related comorbidities, such as Diabetes, Hypertension, Sleep Apnea, High Cholesterol, etc.

Bariatric Surgery also decreases risk of many cancers including breast, colon, prostate, etc.

Yes, you should take a Bariatric Multivitamin daily for the rest of your life. After Surgery, we will follow you closely at regular intervals up to the 1 year mark, and then you should have an annual follow-up visit to check vitamin levels and other routine lab work.

All surgical procedures have some risks, gastric bypass has similar general risks as many other abdominal surgeries, including:

Infection.

Bleeding.

Reactions to anesthesia.

Some complications more specific to a gastric bypass may include:

Internal Hernias. The rerouting of the small intestines creates a defect in the mesentery which is a fatty tissue layer through which the blood supply travels to the intestine. Internal hernias occur when a loop of small intestine gets “stuck” in one of these defects. This can create a small bowel obstruction. Although Dr. Cudworth routinely closes the internal defects, after significant weight loss there is a small risk these defects or holes in the mesentery could open years later.

Anastomotic leaks. In a Gastric bypass we transect and then reconnects the small intestine in more than one place. If the connection point (anastomoses) leaks, it can lead to serious infection inside your abdominal cavity.

Overall, the risk of these complications is low and all can be readily treated. The risks of any bariatric procedure are much less than the risks of morbidity and mortality that come with living with Severe Obesity.