The decision to undergo gastric bypass surgery should not and can not be made spontaneously. While bariatric surgery can be an extremely effective procedure for people living with morbid obesity, it is a very important decision.
Many people mistakenly think that gastric bypass surgery is a one-time surgery that will help them to easily shed off pounds of fat. The reality is that deciding to undergo gastric bypass surgery is making a commitment to long-term weight control and a lifestyle change that includes closely-monitored nutrition and consistent exercise.
Dra. Ana Santos Quiñones desires to help her patients make educated decisions based on their need, health, and commitment. If you think that your life can benefit from the effects of bariatric surgery, please contact Dra. Santos Quiñones at the Institute for Advanced Surgery and Obesity Control today.
Before the Procedure
Dra. Ana Santos Quiñones stresses to each and every person who comes to see her that undergoing gastric bypass bariatric surgery is not a one-time magic cure for morbid obesity. Rather, it is a tool to use and work with each day for the rest of your life to help take and keep off the weight that inhibits being truly free and happy.
To make sure that you are well-equipped to make the right decisions, Dra. Santos Quiñones arranges for a series of consultations that explore virtually every aspect of bariatric surgery and the life it allows. The first consultation is mainly an informative meeting where Dra. Santos Quiñones will take the time to educate you about the procedure. She will help you understand what exactly must happen in preparation for the surgery, what is done during the surgery, and what lifestyle changes must be made following the surgery. You will also be given information about insurance coverage and costs. Dra. Santos Quiñones will take the time to answer any questions or concerns that you may have about the procedure, insurance coverage, or post-operative lifestyle changes.
The second consultation involves your loved ones, typically family, to discuss whether this is a procedure and lifestyle change they all agree with. While bariatric surgery most directly affects you, the patient, family and close loved ones also must play a supporting role in the ongoing weight loss commitments. Dra. Santos Quiñones will continue to answer questions and facilitate discussion between you and your family members to educate them on the gastric bypass surgery and lifestyle changes that will follow. If you decide to undergo bariatric surgery, Dra. Santos Quiñones will need to schedule a series of appointments for you to meet with various specialists before the surgery is actually performed.
Once all of these pre-operative appointments are completed and each specialist approves of going ahead with the gastric bypass procedure, Dra. Santos Quiñones will perform surgery.
[ back to top ]
Roux-en-Y vs. Laparoscopic Gastric Bypass Surgery
When performing an open Roux-en-Y gastric bypass surgery, Dra. Santos Quiñones operates through a four to six-inch incision that is made from just below the breastbone to just above the navel. While open Roux-en-Y gastric bypass surgery has been performed since the mid 1960s, laparoscopic Roux-en-Y surgery has only been available since the early 1990s when tiny video cameras were introduced to the surgical field. For this procedure, the cameras allow surgeons to see into the abdomen by projecting live images onto a monitor. Laparoscopic Roux-en-Y surgery presents a distinct advantage over traditional Roux-en-Y as it does not necessitate the surgeon to make large incisions to see into the area meant to be operated on. Only small incisions are made, allowing patients to experience less pain and minimal scarring after the surgery. Recovery time from physical limitations and pain is shorter. Traditional Roux-en-y gastric bypass poses the advantage of coverage from most major health insurances in Puerto Rico while laparoscopic does not. Long term, both procedures provide the same benefit of weight loss and resolution of comorbities.
[ back to top ]
During the Procedure
Both the open and laparoscopic Roux-en-Y gastric bypass surgeries typically take three steps to complete. The first stage requires the surgeon to use the patient’s stomach to create a small gastric pouch that holds approximately three ounces; ultimately, this gastric pouch will serve as the patient’s new stomach. The original stomach is completely and permanently separated from the new stomach. In order to keep the new stomach from stretching into a larger pouch over time, Dra. Santos Quiñones will make the pouch along the stronger, more muscular side of the stomach.
The second step consists of connecting the bottom part of the jejunum (the middle portion of the small intestine located between the duodenum and the ileum) to the newly-formed gastric pouch. Dra. Santos Quiñones will do this by cutting the jejunum at a point somewhere between 100 and 150 centimeters away from where it starts and attaching the bottom half to the pouch. This new attachment is referred to as the Roux limb. This creates a new path for food to travel down: food enters the mouth, travels down the esophagus to the new gastric pouch, and almost immediately enters the Roux limb, skipping the large, remaining portion of the original stomach altogether.
The remainder of the original stomach is known as the gastric remnant and continues to create digestive juices that are vital to proper digestion, which brings the need for the last step. In the third phase, the upper part of the small intestine that is connected to the gastric remnant is attached to a place on the Roux limb to form a “Y”-shape. This allows the digestive juices formed in the gastric remnant to meet with the food that is passed through the gastric pouch and into the jejunum.
Dra. Santos Quiñones uses the patient’s body mass index (BMI) to determine how far down the newly-created Roux limb to attach the upper part of the small intestine, called the biliopancreatic limb. The distance between the new stomach and the location of the attachment of the biliopancreatic limb establishes the level of malabsorption. Malabsorption results from the fact that the absorption of vitamins and minerals from food that normally takes place in the duodenum and the first part of the jejunum does not take place anymore. Rather, patients must compensate with mineral and vitamin supplements for the rest of their lives.
[ back to top ]
After the Procedure
Undergoing gastric bypass surgery is only the first step in the long journey toward healthy and safe weight loss. Though life after bariatric surgery will require a complete lifestyle change, an entire team of weight loss professionals and loved ones will be there to support you and help you adjust.
For the first few days following your gastric bypass procedure, you may not feel much different in terms of your weight. You will experience discomfort and various levels of pain; Dra. Santos Quiñones may provide a self-administered pain relief system so that you can control the frequency and amount of pain medication ( PCA - patient controlled analgesia).
After the surgery, you will stay at the hospital for 3 to 4 days. A team of nurses will continuously monitor your well-being and vital conditions. Your bandages will be kept fresh to avoid infection and promote quicker healing. During the night following surgery, you will be asked to get up and walk. Depending on your recovery and the tests that your Dr. may order, you will be discharged 3 to 4 days after the gastric bypass surgery.
If you would like to learn more about open or laparoscopic Roux-en-Y gastric bypass surgery, please contact Dra. Santos Quiñones today. She is dedicated to helping patients living with morbid obesity achieve a fresh outlook on life with the help of dramatic and safe weight loss.
[ back to top ]
Dra. Ana Santos Quiñones takes great pride in the drastic changes her patients undergo after bariatric surgery. Explore our gallery to see how bariatric surgery can dramatically improve your body.
[ back to top ]
Dra. Ana T. Santos Quiñones
P.O. BOX 373130
Cayey, PR 00737