Gastric bypass is one of the most used procedures for the treatment of obesity and the problems associated with it. It is considered the “Gold Standard” for the good results it offers both in weight loss and obesity-related diseases, providing well-being and a very good quality of life. Next, Dr. Fernando Schiaffino, general surgeon, specialist in bariatric and metabolic surgery at the Clinica Ricardo Palma, explains everything about this procedure.

Which patients are candidates for gastric bypass?

This surgical procedure is a good option for men and women over 18 years of age with excess weight who are unable to lose those extra kilos with a nutritional regimen or regular physical activity, affecting their quality of life and running the risk of suffering multiple diseases such as: diabetes, hypertension, coronary disease, fatty liver, among others.

What should the patient do before the procedure?

The patient must be evaluated in the doctor´s office, where nutritional habits and personal history will be identified, examined and explained about the programs and treatment alternatives for obesity according to the characteristics of each person. Laboratory tests, abdominal ultrasound, endoscopy, nutritional and psychological evaluation and surgical risk are usually indicated to complement the evaluation and correctly assess the health condition.

Is there a preparation before the surgery?

Yes. The patient must follow a preoperative diet that varies according to the degree of obesity they present.

How is the procedure carried out?

It is a minimally invasive laparoscopic intervention. On average it lasts 1 hour and 40 minutes and general anesthesia is used. State-of-the-art laparoscopes and single-use staplers with automatic triggers with tissue thickness sensors are used. The use of this technology makes the surgery more efficient and lower risk. Also, there is the anesthesia area that has advanced technology (video laryngoscopes, brain wave monitoring, cardiology and ventilation) to provide greater patient safety and reduce the need for medication, as well as drug side effects.

What care is required after surgery?

After the surgery, the patient remains in a recovery room for 2 hours, where he/she is permanently monitored. Then the patient is then taken to his/her room where protocolized care is applied for his/her recovery. 80% of patients are able to return home the next day.

The patient must follow a progressive diet, which will be guided by a nutritionist specialized in bariatric procedures, starting with the intake of liquids, then porridge, chopped, and little by little will return to the usual food. Physical activity and exercises will also be progressive and prescribed during medical follow-up, as well as nutritional and multivitamin supplements.

What results are expected?

Patients usually lose between 75 to 100% of their excess weight, depending on the degree of obesity with which they start, the age of the patient and the associated diseases (providing enormous advantages in the treatment of these, with high rates of resolution/ improvement). The case of patients with type 2 diabetes stands out, since about 85% reach remission/improvement of the disease. These data may vary depending on the type of diabetes, the time of evolution and the number of drugs needed to control it. It also significantly improves fatty liver disease, dyslipidemia, arthralgia, gastroesophageal reflux, among others.

The quality of life after bariatric surgery is very good, thanks to weight loss, the improvement of associated problems and the better disposition and ease for the patient to carry out their daily activities. The idea is that after the adaptation period people have a full and better life than before, finding the right balance. Therefore, multidisciplinary monitoring and controls are necessary.

Dr. Fernando Schiaffino
General surgeon, specialist in bariatric and metabolic surgery at the Clínica Ricardo Palma