part of the pouch to prevent it from dilating. In both
surgeries the food enters the small intestine farther
along that it would enter if exiting the stomach nor-
mally. This reduces the time available for absorption
of nutrients. The procedure is normally done lapa-
roscopically, meaning that the surgeon makes one or
more small incisions in the abdomen and inserts the
necessary tools and instruments through the tiny
holes. He or she can view the patient’s organs via
an inserted camera that displays pictures on a mon-
itor. This method makes for a faster and easier recov-
ery than a large incision.
Jejunoileal bypass. Now a rarely performed proce-
dure, jejunoileal bypass involves shortening the small
intestine. Because of the high occurance of serious
complications involving chronic diarrhea and liver
disease, it has largely been abandoned for the other,
safer proceduresPreparationAfter patients are carefully selected as appropri-
ate for obesity surgery, they receive standard preop-
erative blood and urine tests and meet with an
anesthesiologist to discuss how their health mayaffect
the administration of anesthesia. Pre-surgery coun-
seling is done to help patients anticipate what to
expect after the operation.Aftercare
Immediately after the operation, most patients are
restricted to a liquid diet for 2–3 weeks; however, some
may remain on it for up to 12 weeks. Patients then
move on to a diet of pureed food for about a month,
and, after about two months, most can tolerate solid
food. High fat food is restricted because it is hard to
digest and causes diarrhea. Patients are expected to
work on changing their eating and exercise habits to
assist in weight loss. Most people eat 3–4 small meals a
day once they return to solid food. Eating too quickly
or too much after obesity surgery can cause nausea
and vomiting as well as intestinal ‘‘dumping,’’ a con-
dition in which undigested food is shunted too quickly
into the small intestine, causing pain, diarrhea, weak-
ness, and dizziness.Risks
As in any abdominal surgery, there is always a risk
of excessive bleeding, infection, and allergic reaction
to anesthesia. Specific risks associated with obesity
surgery include leaking or stretching of the pouch
and loosening of the gastric staples. Although the
average death rate associated with this procedure is
less than one percent, the rate varies from center to
center, ranging from 0–4%. Long-term failure rates
can reach 50%, sometimes making additional surgery
necessary. Other complications of obesity surgeryIn this Roux-en-Y gastric bypass, the stomach is separated into two sections. Food is bypassed from the larger stomach to the
smaller stomach.(Illustration by GGS Information Services/Thomson Gale.)Bariatric surgery