Bariatric weight loss surgery methods were first introduced in “1969” (Furtado, 2009, p. 308) and there are many types of gastric bypass surgery but the most common is the “laparoscopic roux en Y gastric bypass” (Christou, 2009, p.1). Laparoscopic roux en Y gastric bypass is used to make a small stomach and involves the surgical redirection of the small intestine farther down the intestinal tract. Because of the smaller stomach pouch much less food is able to be ingested and with the redirected small intestine there is a reduced ability to absorb calories from food causing weight loss.
Before a patient undergoes a laparoscopic roux en Y gastric bypass it is common practice for that patient to meet certain criteria to be considered a candidate for the procedure. In Patricia Choban’s (2002) study in the Cleveland Clinic Journal of Medicine: Bariatric surgery for morbid obesity: Why, who, when, how, where, and then what?, to be considered a candidate for bariatric weight loss surgery one must be morbidly obese with a body mass index of 40 or more or have a body mass index of 35 along with other obesity related co-morbidities (p. 899). If the patient is deemed a candidate than the patient is educated on what to expect after surgery and how their eating habits will be affected. Due to the reduction in the size of the stomach pouch and the redirected small intestine the patient experiences significant weight loss almost from the day of surgery. Most patients are happy with the result from the laparoscopic roux en Y gastric bypass but there are some considerations that must be contemplated before the patient undergoes bariatric weight loss surgery.
Laparoscopic adjustable gastric banding is the positioning of an adjustable band around the upper part of the stomach achieving a similar effect of Roux-en-Y gastric bypass of reducing the stomach pouch. But Laparoscopic adjustable gastric banding is less invasive than Roux-en-Y gastric bypass since the surgeon does not have to surgically resize the stomach and redirect the small intestine to achieve the desired result. The lap-band is an adjustable device that by adding or removing saline from the ring through an inserted port that is located just under the patient skin. The port is assessed by passing a needle through the skin and using a syringe to adjust the saline amount in the lap-band until the desired levels of weight lose is achieved.
As with any surgical procedure there are risks involved with the Roux-en-Y gastric bypass procedure. According to Luís Carlos do Rego Furtado (2010) in the British Journal of Nursing: Procedure and outcomes of Roux-en-Y gastric bypass there are several possible complication form laparoscopic Roux-en-Y gastric bypass. These would include “leaks” of the new stomach pouch or the redirected small intestine that would need further surgery to repair. “Gastrogastric fistula” is an opening that forms between two areas of the digestive system that should not be there. “Small bowel obstruction/internal hernia” is a blockage in the small intestine that prevents food from passing through the digestive tract that can cause pain and hospitalization. “Liver laceration” is a traumatic injury to the liver in the form of a cut or tear. “Wound infection” is an infection at the surgical site that can be minor or life threatening. “Mortality” is the loss of one’s life due to complications of the surgical procedure (p.309).
According to Paul O’Brien (2004) in the ANZ Journal of Surgery: Obesity is a surgical disease: overview of obesity and bariatric surgery “laparoscopic adjustable gastric banding” has later complications in the form of the adjustable gastric band moving out of position, saline leak or gastric erosion (p.203). Laparoscopic Roux-en-Y gastric bypass or laparoscopic adjustable gastric banding should not be looked at as a quick and easy solution to the epidemic of obesity without weighing the possibility of complication and the necessity that patient’s adhere to their follow up appointments as they give “insight into late complications and the success of bariatric surgery” (Wolf, 2001, p. S114)