I am sitting in bed, waiting for surgery.  The physician informed me that in my case they will use the traditional method for gastric bypass due to the fact that I am extremely fat. I am afraid. Different thoughts, images, smell… Memories… It’s some sort of saying goodbye? I am afraid that’s for sure. Second thoughts – is gastric bypass the best solution or not?!

All my life I had two surgeries and both were cesarean operations. Memories are coming slowly and they are so clear. It was a cold and sunny day at the end of October when I entered the hospital. I was young and happy, ready for the big meeting with my son. I knew that the baby was in bad position and that a cesarean operation was necessary. When they asked me to lay down on that special table I felt the fear and the only thought that I kept in mind was the one that my son has to be born in one or another way. Few hours later I have seen him, so small and helpless. Suddenly everything becomes so peaceful. The smell of rain and new born baby……

Second time, even if I knew what was going to happen, I panicked and the only thought was ‘What will happen with my baby! I do not feel him moving!’ We were lucky and the memories from those few days are full of colour as from the window of my room I have seen one cherry tree full of fruits

I have to be grateful to God for my sons as they convinced me to perform the gastric bypass. They told me that even thought they are adults and they have their own families they still need me. For years I have done my best in order to loose weight. No diet was successful and it was even worth as after each diet I gain in weight double of what I have lost. Pills combined with fitness, aerobics remained without solution. I stopped going to gym as people were laughing behind me. It was awful. At this stage is painful even to remember. As I renounced to go to the gym I have started to gain in weight, to eat more and more. It become difficult to breed during a regular walk and climbing stairs become for me a really challenge. At his point I fixed an appointment with the physician and you know the rest. I’m here, waiting for gastric bypass. Just wish me luck as I need a lot.

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I have 32 years and 1.63cm (my record until now) 130 kg … I did not mention that cases of obesity in the family … Not sufar by any other disease and obesity is present in my life at the age of 5 years. Then, I had a banala operation amigdalita and after the covalescenta I started to eat chaotic, uncontrolled and in conclusion I started “I umflu” … Being increased by grandparents, they have left me to eat in the hope that he will come a day when everything will be fine .. In this idea, we made and sports (handball, swimming), but gave no results … After three years, I was at a endocrinolog I crezand any “flaw” hormonala nature … Her doctor told me that before making analyses for potential dereglari hormonal trying to discipline a food .. And we succeeded slabesc more than 25 kg … Now two years, but I moved from my home town and I gave birth … After birth, we started gaining weight and so I reached kilogramele the above … The start and back pain, feet, fatigue … The lack of ambition, I decided to try my luck with a gastric surgery sleeve …

What I would like to ask me, sir doctor, is:
If you opt for an operation type gastric sleeve … what risks exist in the case of a future tasks?
May I want to ask what “operation ireversibila” (versus gastric sleeve pass by?)
What are the optimal time and conditions for a harmonious loss of weight?
The regime will be essential food for the rest of life?

Thank you for your time …

Answer:
I try to answer the rand and how I can express all your questions
Gastric sleeve is part of the group processes restrictive surgery bariatrica (ie surgery to treat obesity). The restrictive (gastric ring, gastric sleeve, vertical banded gastroplastia) done to limit the intake of food, that is restricting food intake. A man who has such a process can not eat much at a dinner for the stomach or has suffered a series of transformations after the surgery (difeite transformations based on process, binenteles). The restrictive and malabsorbtive (gastric by-pass link, diversia biliopancreatica) have a combined mechanism of action so restrictive as well as the food scurtcircuitare by a thin segment of intestine. In this way, the man will eat less and food and will suffer as a process of digestion and absorption. From here, and the need to add food supplements to these patients, especially vitamins, throughout life.
Turning punctual questions.

1. Gastric sleeve and the task. There are several studies that show that women with gastric ring or gastric by-pass tasks can lead to good end, without problems, but obviously that task should be monitored and gynecologist doctor informed that the procedure. Alimentatia mother is enough for the future of the child to develop normally, including a method and malabsorbtiv not only restrictive, as is gastric by-pass-ROM. We found a study on the sleeve, I do not think there yet, but I see no impediment, given that only a restrictive process. There is a recommendation that says as well as the task is not to produce in the first year of making the procedure.

2. Operatie ireversibila means a procedure to amend the definitive anatomy, so there is no possibility to restore them in the future. For example, after removing the ring perigastric human anatomy is again the initial one. Indepartare procedure is not very complicated and therefore not very riscanta. in the case of gastric sleeve to leave a portion of the stomach, actually a lot of it and as such is the final anatomiei amendment, the procedure being ireversibila. The gastric by-pass things are different. Here, after the surgery, result in a small stomach (which determine restrictia food) and which coase directly to intestinmul thin, but not the rest of stomach but leave it out of the digestive transit. I mean, it remains unused. Secretiile gastric they are produced by duoden to remove jejun. The scheme surgery can lamuri better than words and find one on this site. Operation is reversibila in the sense that it may be through a new operation, very simply is not right to reconecteze stoamacul large digestive system and in transit to deconecteze so thin intestinul the stomach and small intestinul thin sewing everything from thin intestine ( so-called anastomaza jejuno-jejunala). In this way anatomy returned to normal.

3. Regarding the time and optimal conditions for a harmonious loss of weight I think, in what will look, you have a serious weight problem (over 60 kg in addition to the normal weight), a long time and I do not think will resolve without surgery. You have 32 years of May and you want to have children. I think gastric sleeve is a good solution for you (May should know more about the behaviour of your food) and I think should be done about.

4. Regime food after gastric sleeve is not drastically. Acidulate drinks should be avoided and excess sweets. Otherwise this operation disciplineaza as you might say, in the sense that you forteaza to eat small quantities of laimnete every meal. But of all the food actually. We have many patients who eat, about their all, and what are normoponderali now or are about to become.

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Gastric bypass surgery is aimed at reducing stomach. Meanwhile, the procedure allows food (quantity of food at a table) to choose another way than through the thin intestin. This means that you get the feeling of satiety faster. Meanwhile, the quantity of food consumed is reduced and the number of calories the same.

The fact that food bolul avoid a portion of the intestine is beneficial to those who have decided to lose weight, as it absorbs much fewer calories. In the meantime, this is seen in the waist thinning. The most applied bypass style is called Roux-en-Y.

In the process of digestion, food passes through the stomach and then come in intestinul thin, the place where most nutrients are absorbed and calories. Then reach intestin thick (colon) where any remains are removed indigestible, in which digesting phase is complete. In the case of intervention type Roux-en-Y, is small sizing stomach size by creating a similar pliu a pocket at the top. To fix pliul thus obtained, doctors use fasteners or a specially designed plastic banda. Stomacul such is operated and then connected directly to the median part of intestine thin, ocolind a good part of the former stomacala mass, but also from the beginning of the intestine (duodenala area). Operation is done by sectionarea a considerable portions of the stomach, or by making a tiny incisions, the doctor is helping in this case the measurement instruments and orientation with a mini-cameras took pictures.

Surgery itself and its consequences
Assume hospitalization of 4 to 6 days, the first two of which are intended to address laparoscopice. Most of those who have chosen to abide by surgical interventions that have returned to their life style usual after about a month. There is one aspect which must be mentioned, namely that normally, gastric bypass surgery to be aimed at people with an excessive weight, obese people, whose health is put at risk the very height of which. Therefore, tehinca because this is somewhat new, intaietate have people with problems. So far nobody knows exactly who are the risks, so it is not easy to find a cabinet to make such operations in case you want to lose just a few kilograms.

What happens after gastric bypass surgery?
Sometimes, gastric bypass surgery causes of ameteli, weakness, lesin, transpiratie excessive or diarrhoea. Symptoms of these are actually a result of the fact that food inainteaza too quickly through the stomach and intestines. Good news is that senzatiile not only persists immediately after lunch. It is noted however that, in case the person who had this operation eat sweets or other products with increased intake of calories, the symptoms are agraveaza. Sometimes, it takes even that person to stay in bed Out, who returned to.

Deziabili candidates considered by doctors are, as I said above, those persons whose body mass index over 40 or those whose life is primejduita of kilogramele more. Even so, people with excessive weight patients become ideal for gastric bypass, if:

* Suffer from obesity by at least 5 years
* Have had in the past problems with alcohol
* Had no psychiatric problems or episodes of depression untreated
* Have aged between 18 and 65 years

All surgery involves some risks, which is why it is very important to wear a sincere and open discussion with your doctor before you decide on performing the surgery. He can sfatui in connection with the May indicated clinics and appreciate the most surgeons in the field.

How gastric bypass surgery works?
Most people who have passed through this experience, tell stories about how easy slabeasca have succeeded in the first 12 months of intervention. A study on this issue revealed that, after surgery, is lost around a third of body mass before the surgery, a period between one to four years. Meanwhile, addressing laparoscopica recorded similar results, if it pierzandu the average 70% of excessive body mass interview at the same time.

Risks of gastric bypass surgery
The biggest risk, which often occurs in the case of surgical interventions, the infection incision. This then causes stomach leaks which preling or in the abdominal cavity instead of intestinal connection, which may result declansarea peritonitei and accumulation of blood in the lungs. The conclusion is that up to one third of people with gastric bypass get to develop at a given moment anemia, osteoporosis or various gastric disorders. Approximately 200 people from 3 lose their life. After surgery:

– Appears deficienta iron and vitamin B12
– The connection between the stomach and intestine is ingusteaza, which causes nausea and varsaturi immediately after lunch
– Approximately 105 of the patients develop ulcers
– Capsele which sets forth pliul inside stomach may be weak, while
– May appear hernia
– Adjusted by stomach bypass may be high, causing cramps and balonari

Conclusion on gastric bypass surgery
It is useful to note that that part of the thin intestinul which deals with the absorption of vitamins and minerals is evitata because the bypass itself implies that ocolirea areas. For this reason, there are deficiencies of iron, calcium, magnesium and vitamins. In the meantime, it may be privatiunea factor declansator of osteoporosis. Therefore, to prevent its occurrence, it is better that the person who had a gastric bypass operation to consult with dieteticianul her punanad therefore the basis for a proper diet, to cover the nutritional carentele.

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Restrictive operations are those most used for losing weight. The food is limited by creating a small bag in the top of the stomach where food comes through the oesophagus. The bag keeps initially about 30gr. of food and extends up to 1kg in time. A hole at the bottom of the bag usually has a diameter of approximately 0.6 cm. The hole keeps the emptying of the bagi and give the feeling of “I ate enough” so you eat less.

Limitative surgery for obesity include gastric banding and gastroplastia with vertical banding. Both operations serve only to limit consumption of food. They do not intervene in the normal digestive process, as happens in the case of gastric bypass surgery.

What is gastroplastia with vertical banding?
Known as “capsare the stomach,” this operation is a type of surgery known limitativa of weight control. During the operations, using fasteners or strip to create a small stomach bag.

What are the risks associated with VBG?
VBG’s risks include:
• Erodarea band used to create bag stomach.
• Destruction line captusite used to create bag stomach.
• Scurgerea gastric juice in the abdomen requiring emergency surgery.
• In a small number of people who do the operation (less than 1%), infections can occur or death.

What is gastric banding?
During this procedure, a banda made from a special material is placed around the stomach near the upper end, creating a bag and a small hole in the crossing more than a stomach that remained.
What are the risks of gastric bandingului?
The risks associated with gastric bandajul are similar to the risks associated with VBG.

How to make changes in diet after surgery?
After surgery limitativa, usually can eat only a quarter to half a cup of food without causing discofort or nausea. Lichidele are limited to inghitituri small and should not be mixed with food because the new small stomach is not wide enough for you and food and liquids at the same time. Also, food mestecata be fine. Happy people are losing the ability to eat than a date. Therefore, it is necessary to eat several times a day (8-10 small meals) to obtain the necessary nutrients.

How much weight can you lose after gastric bypass surgery?
Surgery limitativa lead to a significant lessening in most patients. However, the rate varies slabirii and weight may return in some cases.

Information on gastric bypass surgery
Operatiile of gastric bypass combine to create a small bag of stomach to limit food consumption with the construction of a bypass with duoden and other segments of the intestine to cause thin malabsorbtia (decreasing ability to absorb nutrients from food).

What types of gastric bypass surgeries are there?
• Gastric bypass Roux-en-Y (RGB). This operation is the most frequent gastric bypass operation used. First, it creates a small stomach bag by capsarea with a portion of the stomach or bandage vertically. This limited much food you can eat. Then, in the form of the Y thin intestine is attached to the bag to allow food to ocoleasca duodenul. This causes reduced absorption of calories and nutrients. This operation can be done now with a laparoscop (an instrument as a thin telescope to see inside the abdomen) to some people. This involves the execution of small incisions and generally have a less time for recovery.
• Gastric Bypass extensively (diversie biliopancreatica). In May this operation complicated by gastric bypass, portiunea bottom of the stomach is remover. Punga little that remains is connected directly to the final segment of the intestine thin. Although this operation has given good results of lessening, is not so used because of increased risk from nutritional deficiencies.
Operatiile of gastric bypass which causes malabsorbtie and limiting the quantity of food produced more weight loss than limiting operations, which only decrease consumption of food. People who do bypass operations generally lose two-thirds of extra weight in 2 years.

There are risks associated with gastric bypass surgeries?
Yes. People who have passed through this operation risked following:
• Intinderea pungii (stomach to enlarge with time, intinzandu to size before surgery).
• Eroziunea lane (banda to close a part of the stomach is dezintegreaza).
• Destruction captusirii (banda and capsele fall, anuland operation).
• Scurgerea gastric juice in the abdomen
• Deficiencies nutrition which causes health problems.
Gastric bypass surgeries can also cause “dumping syndrome”, in which stomach contents move too quickly through intestinul thin. Symptoms include nausea, weakness, transpiratie, lesin and, occasionally, diarrhoea after lunch, as well as the inability to eat sweets without becoming very weakly. May arise from kidney stones because of losing weight quickly. They can be dissolved with medication taken after surgery.

What health problems can result in nutritional deficiencies?
Absorbtia limited vitamin B12 and iron can cause anemia. Lack of assimilation calcium can cause osteoporosis, and metabolic diseases of the bone. People who have passed through this operation should take nutritional supplements that usually prevent these deficiencies.
As for bypass surgery is more Extensive even greater risk of complications and nutritional deficiencies. People who have passed through extensive operations bypass the normal digestive process requires not only a monitoring closely, as well as food and medicines for special whole life.

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This article is for people, or do you think, a derivative of the stomach. Their care from May deviate from what is described here because it is suitable for answers to your individual needs, so it is important that the recommendations of the surgeon.

What are the participants?
Derivation of the stomach is a kind of weight loss surgery, which works by letting your stomach and the removal of part of your small intestine to make your digestive system shorter. That means you can eat small meals and your body takes fewer calories with the food that you eat.

The operation is carried out under general anaesthetic. This means that you asleep during the procedure. Depending on the surgical technique, you need to stay in hospital, three to five days.

Your doctor will explain the benefits and risks of using a derivative of the stomach, and also discuss alternatives to the procedure.

Preparing for the operation
The hospital you a questionnaire before approval. Your responses help the staff of the hospital to plan for you, taking into account your health history and the whole experience of hospital care. You will be asked to complete the questionnaire and return it in a period of three days.

Two or three weeks before your surgery, you will be asked to attend a pre-approval for a clinic in blood pressure and the review of routine blood and urine analysis.

If you usually take drugs (tablets, for example, blood pressure), continue to take, as usual, unless your doctor told you specifically not to do so. If you are not sure that your medicine, please contact the hospital.

Before you go to the hospital, you are asked to follow some instructions.

Have a bath or shower at home on the day of registration.
Remove all makeup, nail polish and jewelry. Rings and earrings that you prefer not to delete can usually be covered, tape. Follow the instructions of the fasting in your letter for approval. In general, you do not eat or drink for six hours before the anaesthesia.  If you are in the hospital, the nurse is a bit of simple tests such as checking the heart rate and blood pressure, urine and test.

May you be invited to the compression from the bottom to help, transport and the formation of blood clots in the veins of the legs (deep vein thrombosis, deep vein thrombosis). May you also the subject of an injection of a blood-thinning drug called heparin before the surgery. For more information, please see the different cards BUPA health, deep vein thrombosis and low compression.

Your surgeons and anaesthetists visit before the surgery. This is a good time, all questions remained unanswered.

About Operation
Your doctor will staples surgery, a bag from the upper part of the stomach. A section of your small intestine is then cut out what is actually shorter. It is back to the bag, so that food bypasses part of your digestive system and is less easily absorbed by the body. Derivation of the stomach can be done keyhole (laparoscopy) or open surgery. The operation in May last two to three hours.

Keyhole Surgery
About five small denominations (one to two centimeters long) are on your chest and abdomen. Your doctor is a tube-type telescope camera in a glass, and shows the area of research, either directly from there, or photos, he sends a screen. This happens especially with the help of surgical instruments. Then the skin cuts are equipped with two or three stitches.

Surgery opens
A single section (about 30 cm long) is in your upper abdomen. The intersection will be closed by clicking points and brackets.

It is of antibiotics during the operation to minimise the risk of infection by the bacteria, of course, in your gut.

After the operation
It does no longer in the operating room, the heavy dependence in which you are seen. They are on machines, the activity of the heart and other systems of the organism. Once the medical team is pleased with the progress made in your room.

Back in the service
A nurse is the operation of the site and monitor your pulse and blood pressure at regular intervals.

May you have a tube through the nose to your stomach for the first day or two. This draws the air and liquids from your stomach prevents you from, nausea and swollen.

For the first 24 hours, you may drink clear liquids. After your doctor or a diététiste May start of a liquid diet. If you do not drink, you have a drop in the arm around them hydrated.

May you have a catheter for the removal of urine from the bladder into a bag next to your bed. May you have a short pipe a small hole in your stomach. This draws the liquid into a bag.

Your doctor visits for your progress and answer all your questions about the functioning. They usually have an X-ray taken to the derivation of the stomach that works, and there is no leakage. May you swallow the liquid, the X-ray. Ask your doctor for more details.

May you have an intermittent compression pump together with the blood platelets at the bottom of the legs. In blowing the blood platelets, the pump in good health promotes blood circulation and help in the prevention of deep vein thrombosis.

They are encouraged, and out of bed to move, as this to prevent pneumonia and blood clots in the legs. May you have daily injections of heparin for a week or two. May you be shown how to inject themselves at home.

You must change the course of life and after a strict diet after the drainage. You need liquidated or puree food for the first few weeks, so that the new facility in your digestive system a chance to heal properly. Your diététiste or a surgeon, you more information.

The return home
Before returning home, your nurse will give you some tips for the care of the healing of wounds (s), hygiene and bathing water. For more information, please see the separate entry BUPA health, care of surgical wounds.

Your nurse will give you a telephone number for the hospital, if you should view to making recommendations, and a date for an appointment.

After your return home
If you need it to continue to take pain medication, as defined by the clinic. Each medicines you dissolvable should be prescribed.

Their bites are usually removed before leaving the hospital. The skin of the base are usually in 12 to 14 days after the operation. Please contact with the hospital if you have concerns.

Decide, a derivative of the stomach
A derivative of the stomach is an operation, the range will change the way the digestive system. For most people, the benefits of losing the excess weight are much bigger than the disadvantages. However, the action is a risk factor. To a decision having regard to the situation and to give your consent, you must be aware of possible side effects and the risk of complications.

The side effects are undesirable, but most of the time for a successful treatment. Then you could spots, pain and swelling of the skin around the healing of the wounds (s) for some days.

You think May or sick, after eating, especially if you try to eat. If you eat foods gezuckerte can do it, you feel weak and sweaty. This is called the “dumping” syndrome. They have generally need take vitamin supplements because of the low calorie diet, and your intestines absorb less well than before the surgery.

The complications are problems that occur during or after surgery. Most people are not affected. The potential complications of the whole surgery include an unexpected reaction to the anesthesia or excessive bleeding during or shortly after surgery. Blood Transfusion May be replaced required to secure the blood lost.

Some of the specific complications to a derivation of the stomach are listed here.

An infection of the wound. Antibiotics are for surgery to help prevent.
To a maximum of six weeks after the operation, it is possible to a blood clot (thrombosis) in the vein in the leg. The clots can become detached and cause a crash in the lungs. In most cases they are treated, but they can live a life in danger. The low compression, intermittent compression pumps and blood-thinning injections are used to prevent deep vein thrombosis.
During the operation other organs of the abdomen May accidentally damaged. The points at which the intestine, could escape again in the first few days. These complications are rare, but May need more than one operation.
There is a small risk of death during or shortly after surgery.
It is possible May not have enough weight or lose weight and returning to the functioning of May, must be repeated.
If you lose weight quickly, there is a risk of gallstones in the gallbladder. These can be painful. May your doctor remove the gall bladder during the operation.
Ask your doctor to explain how these risks apply to you. The risks are detailed from person to person. This is one of the reasons why we do not also the statistics here.

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