gastric bypass/stomach stapling ??

  1. I have a good friend who is seriously considering having this surgery done. I have never taken care of pts who've had this procedure and don't know anyone who has.

    This really scares me because of the things I've read about it, as far as SE. blood loss, etc.

    My friend is a copd pt, on home 02/2l, still smokes some, iddm, overweight and on prednisone,-- the whole works. She said the surg told her they would be rerouting the bowel to the stomach,--what is this??

    Also her pulmonoligist wants to be in the OR while she is having the procedure.

    Could y'all please give me some info from actual cases you've seen and cared for, as well as how these pt's do 6mo to a yr down the road.
    Last edit by rjlrn95 on Jan 19, '02
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  2. 50 Comments

  3. by   NicuGal
    I have 2 friends that have had that done....by two different surgeons where we work...the two surgeons manage their patients very differently and do the surgery differently too. One uses an incision that looks like a V, the other uses a vertical incision from sternum to lower abd...he also uses, if you may..a jack to lift the ribs up for the procedure..OUCH..the other doesn't.

    The one will not let them have any solids, not even pureed for quite a while...like 3-4 weeks. The other starts pureed on about the 5th day. They both had big old NG's down for about 3-4 days. They had PCA pumps for about 3 days after. One girl had a stricture in her after, near her esopagus....they tighten everything up and had to be dilated. The other girl had her spleen nicked and lost that and got 3 units of blood. The other girl didn't need any blood.

    They staple the stomach to make it smaller and they almost do like a fundal tightening too. Then they bypass part of the duodenum so that there is less absorption. They have to take B6 supplements and other vitamin supplements. They are off work 6-8 weeks.

    The one girl had hers in the summer and has lost 100 pounds..she says she feels great. The other gal just had hers last week...she is a bit rough around the edges, but is doing fine.

    I think it is a risky surgery, but if your life depends on it, it can be worthwhile.
  4. by   willie2001
    http://www.asbs.org/html/story/ch_4.html Try this site for a lot of good info about surgery for obesity. We have just begun to do surgery for obesity at my hospital and so far our patients have done well postop. They are really no different to take care of than a patient having any other type of big abdominal surgery. Some may come back on the vent. All of our patients go to SICU overnight. I hope your friend, if she opts for surgery, does well. It is a very drastic step and not without risk, especially in regard to her pulmonary status.
    Last edit by willie2001 on Jan 20, '02
  5. by   willie2001
    If the link in my previous post doesn't work just by clicking, type it in to your computer and get connected that way. One time I clicked and it worked, the next time it didn't. I hope you don't have trouble finding the site, because it really is informative.
  6. by   EndoRN
    It is my understanding that this is an elective procedure, done for morbid obesity. I'm surprised that a surgeon would perform it on your friend, in light of all the risk factors from her other health problems.

    Amy

    I work in GI and see quite a few of the patients that have had this done. In most incidences, the procedure fails.
  7. by   dtweed
    I had this procedure done almost one year ago. I would do it all over again. In order for me to lose weight, i can onlly eat 800 calories a day. Not much. I had what they call a rouenx y. They staple the stomach, make the opening between the stomach and small intestine smaller and by pass part of the small intestine. We have a gastric bypass support group in my local town. I know of at least 30 people who have had it done. All of us are happy with the results. A few even had complications and would do it again. Oh by the way I've lost 90 lbs, no longer take HTN meds, and blood sugars are normal without meds. That is what this surgery will do for you.
  8. by   KRVRN
    Let me just add that apparently, it can be done laprascopically. (sp?) My mother-in-law is having it done that way on Monday. She was saying it's possible to have it done that way, but some pts still need the open procedure because the laprascopic rods are only so long and some obese pts are too big through the middle for them to reach.
  9. by   klhs
    I had vertical banded gastroplasty 6 years ago... I lost 135 pounds. I have had no problems with it... in fact I even went thru a pregnancy 2 years ago without complications. Would I do it again? YOU BET! I feel so much better and I am healthier
  10. by   rjlrn95
    Thanks so much for all the replies so far, I do appreciate the info and will be forwarding this on to my friend along with the link I was given.

    Anyone one else w/info please cont to send and I have a couple more ques.

    Are you limited to sm amts forever and what about liquids--
    Limits on type, kind and amt?
  11. by   klhs
    When I first had the surgery, I was limited to 3 teaspoons at a time. I couldn't eat and drink at the same time for a while... had to wait 30 minutes after I ate to drink. There was no restrictions placed on what I could eat or drink.. only the amounts.

    Also, over time the stomach gradually expands... and I can now eat more now... but I still don't eat like I did - and one VERY important thing, even though you lose the weight after the surgery without much effort... a behavior modification has to occur also... or eventually you will gain the weight back... after stretching out the stomach again.

    I wish your friend the best of luck..
  12. by   colleen10
    Hi there,

    I used to work with a 67 year old woman who had the surgery done about 9 months ago. She is now in terrific shape and still loosing weight. Some of the important aspects of her surgery were (and I'm not a nurse yet, so if this doesn't sound right please understand):
    during the surgery they actually lifted up and went under her diaphragm. She said the doctor said that is the most painful part of the operation
    She was hospitalized for a week, which isn't the norm. She had an extended stay due to other health issues
    She lost 21 pounds in her first week while she was at the hospital
    Before she had the operation she HAD to go to attend a class which deals with the physical AND emotional aspects of the operation. The class was aobut 12 hours in length.
    She basically had to learn to eat all over again. If she ate too much she would throw it all up. It has taken her many many months just to get used to the amount of food she can eat and understanding her bodies "signs" that she is full
    She has a friend who is male who has lost too much weight. His doctors have now put him on a high cal diet.

    She said that she would recommend to others to have the procedure done. She has battled with obesity for most of her life.
    She also said that the class she had to take was very good and thinks everyone should take something like it before they have the surgery.
  13. by   TracyB,RN
    A new coworker had this done 9 months ago.
    She had the vertical incision, insurance paid 100%, in hospital a week after, back to work in 4 wks ( her choice - docs told her 6-8wks). She has lost 95 pounds, will probably be having surgery again in april to remove the excess skin
    She eats 3-4 oz of food at a time, if more than that, she gets diarhhea. But is thrilled with results & would do it again
  14. by   Michelle_nurse
    I knew someone that had it done, years later, she gained it all back.........then again it is all about lifestyle, and obviously she didn't change a thing!

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