Gastric Bypass is probably the “gold standard” operation for obesity.
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It is commonly thought to work by a combination of restriction due to the small gastric pouch and impaired absorption of nutrients due to the bypass component, but this is probably incorrect. With modern approaches to gastric bypass, where only a limited amount of the small bowel is actually bypassed, there is little clinical evidence that there is any failure of absorption of the nutrients in the food, and thus there is only a very small chance that the nutritional problems that can follow operations such as a duodenal switch, will occur.
The operation is technically more difficult, a more major undertaking and subject to a greater risk of immediate post-operative complications than the band. Nevertheless, in many individuals it may be the safest operation because it will more effectively reduce the risks of complications such as diabetes and high blood pressure than will operations such as the gastric band. It is important that the operation is carried out in a hospital with specialist facilities where a large number of cases are being carried out each year, and where complications can be managed without the need to transfer the patient to an NHS hospital.
The Gastric Bypass is probably the operation of choice for anybody with a BMI greater than 40, or a BMI greater than 35 if there are additional problems such as diabetes, high blood pressure or arthritis. Average weight loss with the bypass is approximately 70% of excess weight and it is not uncommon for patients to come down to the normal range of BMI, under nutrition however is very uncommon.
Whilst there are risks with the bypass operation, the risks are far greater in individuals who are very obese and who have also developed serious complications as a result of their obesity.
In the past, Bypasses were performed as open surgery involving large scars and long recovery periods. Some surgeons still perform open gastric bypasses. Professor Michael McMahon was responsible for pioneering keyhole (Laparoscopic) Gastric Bypasses in the UK and has been performing them ever since.
Gastric Bypass costs
|BMI up to 60||£8,950|
|BMI over 60||£11,995|