Thursday, 29 January 2009

Time for another posting. I am on my diet still fed up with the lack of choice of food, try a vegetarian fat free diet…. Fortunately I still don’t mind tinned tomatoes… baked beans are like a taste from heaven… cottage cheese on Ryvita… well I don’t care if I never see a Ryvita again… trouble is the packet keeps smiling at me every time I open it… do you think it knows we are now “friends” for life? I am hoping my diet will actually drastically improve once I have had the operation… I am sure it will… Im just looking forward to a nice piece of Poached salmon…. Mmm

Ok so I promised you more information…. Form what I know and from carrying out research,

Gastric Bypass
There are several varieties of bypass, but all involve the creation of a small stomach pouch to restrict food intake and bypasses of the duodenum and other segments of the small intestine to reduce the absorption of calories and nutrients from food. The operation is more extensive than for a band. This can be performed both open and laparoscopically (keyhole). I had one doctor argue with me that bypass operations could not be carried out using Keyhole surgery, but it can, although maybe not for everybody.

Laparoscopic surgery involves making a series of small incisions and inserting long tube-like instruments through them. The abdomen will be filled with gas to help the surgeon view the abdominal cavity. A camera will be inserted through one of the tubes that will display images on a monitor in the operating room. In this manner, your surgeon will be able to work inside your abdomen without making a larger incision. Specialized instruments are used to laparoscopically perform the Roux-en-Y Gastric Bypass. This is the same gastric bypass as has been performed with the traditional open approach (large incision), but with superior results.

Roux-en-Y Gastric Bypass (RGB)
Roux-en-Y gastric bypass surgery uses a combination of restriction and malabsorption to ensure a significant weight loss. During the procedure, the surgeon creates a smaller stomach pouch. The surgeon then divides the small intestine and attaches it to the pouch. The type of connection bypasses a large portion of the small intestine, which absorbes calories and nutrients. Having the smaller stomach pouch causes patients to feel fuller sooner and eat less food; bypassing a portion of the small intestine reduces the amount of calories that can be absorbed by the body.

Biliopancreatic diversion Gastric Bypass (BPD)
In this more complicated version, portions of the stomach are removed and the small pouch that remains is connected directly to the final segment of the small intestine. This means that most of the small intestine (duodenum and jejunum) is bypassed, resulting in substantial reductions in calorie and nutrient absorption.
The diagram shows what effect a Biliopancreatic diversion has on the stomach 1) The small intestine is connected to the stomach pouch 2) here we show the removed portion of stomach area. 3) The Pancreas
The risks of gastric bypassAs with any surgery, there are operative and long-term complications and risks associated with gastric bypass, including:
Bleeding (haemorrhage).
Complications due to anaesthesia and medications.
Pulmonary emboli (blood clots on the lung).
Deep vein thrombosis.
Dehiscence (wound breakdown).
Leaks from staple line.
Injury to the spleen.
Marginal ulcers.
However, the risks of the procedure nowadays are very small. Most published reports show that the overall mortality rate for gastric bypass surgery is less than 1%. It’s also important to note that not only does bypass result in reduced absorption of calories, it may also reduce absorption of important vitamins and minerals such as iron, vitamin B-12 and calcium. Deficiencies in these nutrients can lead to many problems. Iron deficiency causes anaemia and weakness and deficiencies in calcium can cause osteoporosis. Lack of daily B-12 can lead to neurological problems. This is why patients undergoing gastric bypass are recommended to take a daily vitamin and mineral supplement. "Dumping syndrome," in which the consumption of sugar causes abdominal cramping and diarrhoea, can also occur. Some people will also regain some weight in subsequent years.
The general criteria used to determine whether you're a candidate are listed below:
BMI >40
BMI 35-40 with co-morbidities (other medical conditions such as diabetes, heart disease, etc)
Well-informed, motivated patient
Previous attempts at medical weight loss programs
Absence of endocrine orders that cause obesity

What are the benefits of gastric bypass?For the seriously obese, the benefits of the gastric bypass procedure very much outweigh the risks. In general:
75% of patients are expected to lose 75 to 80% of their excess body weight, most of which is lost in the first two years following surgery.
Major improvements in risk factors for heart disease and cancer.
Around 70-80% of patients with hypertension will be off medication and cholesterol levels will fall.
Most type II diabetics will be cured.
There will be major improvements in a whole range of weight-associated conditions. These could include sleep apnoea, asthma, joint pain, arthritis, reflux, fatigue, shortness of breath.
Patients report less depression, improved self-esteem and confidence along with an overall increased sense of well-being.

Here is an interesting article with regard to the diabetic "cure" thing

Ok I think I have gone on long enough for this blog I was going to mention the DS but I will leave that for next time. Another type of operation which is less invasive came to my attention today which is the EndoBarrier is under going clinical trails. I will mention a bit more about this one next time to, it look quite interesting.

These factual blogs seem a bit boring but I think people might find it interesting the different types of op available…. Well this is also to fill in time until I start my own real life pages….

So until next time.....

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