Open Gastric Bypass
Doctor Answers 3
Open Gastric Bypass - is it still perfomed?
Most cases can be performed via the laparoscope even with a BMI of 70. Converting to an open technique adds significant morbidity to the patient and surgeons try to avoid this in most situations unless conversion is necessary. You may be a candidate for the DS procedure rather than a gastric bypass.
Consult with your bariatric surgeon, unless there are major contra-indications a BMI of 70 can be performed laparoscopically.
Gastric bypass with bmi of 70
Gastric bypass surgery should only be performed laparoscopically by experienced bariatric surgeons. The risks of surgery increase with a BMI more than 60. We usually recommend putting patients on a liquid protein diet prior to surgery to get their BMI closer of 60 and lower the risks of surgery. All bariatric surgeons including sleeve gastrectomy have higher risks is high BMi patients. It is usually pretty simple for patient to lose weight on a liquid protein diet prior to surgery knowing they have that surgery date to look forward to.
Open Gastric Bypass or Laparoscopic Sleeve Gastrectomy
Bariatric surgeons still perform open surgery, however it is extremely rare. Open bariatric surgery is associated with multiple complications such as wound infections and incisional hernias. There is a much better option in high BMI patients than an open gastric bypass. A BMI of 60 or above is categorized as super morbid obesity. A laparoscopic Roux-en-Y gastric bypass in these patients is technically very difficult due to the size of the abdominal wall, the size of the intra-abdominal fat and the size of the liver. Due to these technical aspects of the procedure, the risk of leak and other complications are increased. I think that a laparoscopic sleeve gastrectomy is a much better procedure in higher risk super morbidly obese patients. It is a technically easier operation than a Roux-en-Y gastric bypass and has a much lower complication rate for this patient population. The sleeve gastrectomy can also be the first stage in a two-stage procedure. Once the patient has lost a significant amount of weight, and if he/she is still morbidly obese, it is safer to then convert the laparoscopic sleeve gastrectomy into a gastric bypass or a duodenal switch. The sleeve gastrectomy started as a procedure for high-risk patients but is now used as a primary procedure for lower BMI patients as well.
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These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.