Gastric Bypass

Hi, I'm Sanjay Perkiaster. I'm a consultant bariatric surgeon and I carry out weight loss or obesity procedures, also known as bariatric procedures. Today I'm going to talk about the gastric bypass. This is a well-known procedure which we carry out with keyhole or laparoscopic surgery. Within this procedure, the point of the operation is to reduce the size of the volume of of the stomach from that of a watermelon to that of a small egg. This is carried out with stapling devices used in the keyhole surgical technique. This partitions the stomach, but the stomach is not removed. The small intestine is then disconnected down below and is joined to the new stomach pouch. In order for food and digestive juices to then merge later downstream and allow normal absorption of calories, foods and vitamins, the small bowel is then joined or anastomosed to itself at least a metre downstream. This is known as a classic Roux-en-Y gastric bypass. The benefits of this operation include weight loss, resolution of diabetes, high blood pressure, help with fertility and infertility problems, reduction of medications such as lipid lowering or cholesterol lowering tablets, the alleviation of obstructive sleep apnea or heavy snoring for many patients using CPAP devices at home which can be noisy, cumbersome and expensive. The other benefits are an eventual reduction in any cancer risk, cardiovascular risk which includes the risk for stroke, heart disease and heart attack, and also usually an increase in the quality of life, particularly as joint pains, particularly from arthritis, back pain, knee pain, hip pain, all tend to get better when patients carry less weight. So what are the risks of this sort of procedure? Well first of all, in high volume units such as ours, and we were one of the first international centres of excellence recognised worldwide and by the US for bariatric or weight loss surgery here in the UK. We carry out high volume surgery and so our incidents of high risk, large complications such as leak, bleeding or mortality is extremely low and is actually lower than the average complication rate in your local hospital for having a keyhole gallbladder or hernia operation. However, potential complications can include nausea, vomiting, pain, clots in the legs or lungs, excess skin or subcutaneous tissue which forms when you lose a lot of weight rapidly. This can be corrected with plastic surgery usually 2-3 years down the line when your weight has become stable. There is a potential for something called dumping syndrome where if you eat too many sweets or carbohydrates you can get low blood pressure, flushing, sweating and diarrhoea. There is a small risk of what's called internal herniation or hernia appearing at the port sites where your operation was carried through. There's a small risk of bowel obstruction or blood transfusion needed but this is really many many hundreds to one. In order to get more information, you can go to our website or you can contact us directly to talk through the pros and cons of this kind of surgery and whether it's a good fit for you. If you're interested in other forms of bariatric or weight loss surgery or surgery to help you with your diabetes and reduce your medication load, either tablets or insulin, you can also look at sleeve gastrectomy, mini gastric bypass and gastric band surgery. I'm Sanjay Perkiasta, I'm a consultant bariatric surgeon and I'm the director of the London General Surgical Clinic here in central London. Thank you.