Obesity surgery (also called bariatric surgery, gastric bypass surgery, or gastric restrictive surgery) is an operation that can help you lose weight when other treatments for severe obesity have not worked. Severe obesity is defined as being more than 100 pounds overweight or having a body mass index (BMI) of 40 or higher. The BMI is a measure of your weight in relation to your height.
The aim of obesity surgery is to change the gastrointestinal (GI) tract to limit the amount of food you can eat and change how food is digested. You will feel full more quickly when you eat, which means you will eat less.
Obesity surgery may be done if you have:
Severe obesity (BMI of 40 or more)
BMI of 35 and an illness related to your obesity, such as diabetes, heart disease, or arthritis
Failed to lose weight after 6 months of documented weight loss treatments
How is obesity surgery done?
Before the procedure:
Your healthcare provider will ask you to sign a consent form for obesity surgery. The consent form will state the reason you are having the procedure, what happens during the procedure, and what you may expect afterward.
There is risk with every treatment or procedure. Risks that sometimes occur with obesity surgery may include anesthesia problems, pain, infection, bleeding, or bowel problems. Ask your healthcare provider how these risks apply to you.
Tell your healthcare provider if you are allergic to any medicines.
Tell your healthcare provider if you are taking any medicines, including nonprescription drugs, herbal remedies, or illegal drugs (if any).
You will have a small tube (IV catheter) inserted into a vein in your hand or arm. This will allow medicine to be given directly into your blood and to give you fluids, if needed.
During the procedure:
A cardiac (heart) monitor may be used to keep track of your heart rate and rhythm.
Your blood oxygen level will be monitored by a sensor that is attached to your finger or earlobe.
You will be given a sedative, which will help you to relax. This is usually given in your vein (IV).
You will be given medicines to prevent pain during your surgery. These may include:
Regional anesthesia: Numbs the lower half of your body while you remain awake.
General anesthesia: Relaxes your muscles and puts you to sleep. A breathing tube is usually put in your throat when you have general anesthesia.
You may have a small tube (catheter) placed into your bladder through the urethra (the opening from the bladder to the outside of the body) to drain and measure urine from the bladder.
The surgeon will make one large cut or two or more very small cuts in your belly. If small cuts are used, your provider will put a lighted tube with a tiny camera (called a laparoscope) and tools through the small cuts to see the stomach and intestines.
Obesity surgery may be done in the following ways:
Gastric banding (LAP-BAND): A band is placed around the upper part of the stomach. It can be tightened or relaxed to control the size of the stomach and limit the amount of food you can eat at one time.
Roux-en-Y Gastric Bypass Surgery (RYGB): A procedure in which much of the stomach, which is normally the size of a football, is stapled shut. A small pouch of stomach, about the size of an egg, is then connected to the small intestine.
Vertical sleeve gastrectomy (VSG): A procedure in which most of the stomach is removed, leaving a small tube of stomach, called a gastric sleeve, connected to the intestine as it was before the surgery.
Biliopancreatic diversion with a duodenal switch (also called BPD-DS or duodenal switch): A procedure in which a large part of the stomach is removed, leaving a gastric sleeve. The stomach will still move food into the top part of the small intestine called the duodenum. The duodenum will be connected to the top part of the large intestine.
After the procedure:
You will be checked often by nursing staff.
There will be a dressing on your belly. The dressing will be checked and changed by your provider or the nursing staff as needed.
Your provider may prescribe medicine to:
Treat or prevent an infection
Replace vitamins and minerals that your body is no longer able to absorb from the food you eat
Relieve gas and bloating
What can I do to help?
You will need to tell your healthcare team if you have new or worsening:
Abdominal cramps or pain
Black, tarry bowel movements
Blood in your bowel movement
Vomiting, especially with blood or dark brown or black material in the vomit that looks like coffee grounds
Signs of infection around your surgical wound. These include:
The area around your wound is more red or painful.
The wound area is very warm to touch.
You have blood, pus, or other fluid coming from your wound area.
You have chills or muscle aches.
Ask questions about any medicine, treatment, or information that you do not understand.
How long will I be in the hospital?
How long you stay in the hospital depends on many factors. The average amount of time to stay in the hospital after obesity surgery is 1 to 3 days.
Developed by RelayHealth.
Acute Care Advisor 2015.1 published by RelayHealth. Last modified: 2014-04-30 Last reviewed: 2014-04-24
This content is reviewed periodically and is subject to change as new health information becomes available. The information is intended to inform and educate and is not a replacement for medical evaluation, advice, diagnosis or treatment by a healthcare professional.
Obesity Surgery: References
Feldman, M, Friedman, L, & Brandt, L. (2010). Sleisenger and Fordtran’s gastrointestinal and liver disease [9th ed.]. Retrieved from http://www.mdconsult.com/.