Malabsorptive (Weight Loss) Surgery

Malabsorptive weight loss procedures for weight loss include biliopancreatic diversion and biliopancreatic diversion with duodenal switch.

These malabsorption weight loss surgeries:

  • Create much more intestinal bypass and, therefore, more malabsorption
  • Reduce the stomach size by two-thirds
  • Do not severely restrict food intake

Restrictive vs. malabsorbative bariatric surgery

  • Restrictive bariatric surgery reduces the size of the stomach. This limits the amount of food that can be consumed and creates a feeling of fullness.
  • Malabsorptive bariatric surgery limits the amount of nutrients the body absorbs by bypassing a portion of the small intestine.

Malabsorptive Weight Loss Procedures: What to Expect

Here's what to expect if you're considering this nasogastric tube procedure.

During malabsorptive surgery

After completing the admitting paperwork, you will go to the pre-op holding area where you will receive an IV and meet the anesthesiologist.

The operation takes 90 minutes to three hours, depending on factors such as prior surgery and whether the gallbladder requires removal.

After malabsorptive surgery

  • You can expect to stay in the hospital for two to three days.
  • When you wake up from surgery, you will have:
    • An IV in your arm
    • A supplemental oxygen tube in your nose
    • A urinary (Foley) catheter, which we usually remove the day after surgery
    • A PCA (patient-controlled analgesia) pump with a button for pain medication
  • The night of surgery, you will work hard on breathing exercises and walk as much as possible.
  • The morning after surgery, you will generally have an upper GI to evaluate the integrity of the staple connections. If the test is normal (usually the case), you will begin taking small amounts of liquids.
  • On the first day after surgery, we will remove the tube from your nose. About half of our patients also have a small plastic drain under their skin, which we remove as well.
  • On the second day after surgery — if you're doing well with liquids — you can begin having some "mushy" foods. This is the beginning of re-learning to eat, and the first lesson is not to eat if you feel full or nauseated. This means that you will only have a nibble or two.

You should be ready to go home on the second or third day after malabsorptive weight loss procedures.

To be ready for discharge, you must:

  • Be able to walk independently
  • Have reasonable pain control on oral medications
  • Be able to tolerate drinking enough liquids to stay hydrated and maintain yourself

Gastric Tube Complications

The surgical complication rate with malabsorptive procedures is higher than with other weight loss operations. However, weight loss results and improvements in health conditions can be significant.

Your bariatric surgeon will review all potential risks and complications of malabsorptive surgery with you prior to the procedure.

Dumping syndrome 

After discharge, you will need to follow the post-surgery diet, as advised by your doctor. Overfilling the tiny pouch results in pain or vomiting.

To avoid "dumping syndrome," you must stay away from sweets.

Dumping syndrome occurs when large volumes of food in the stomach move too quickly through the small intestine, frequently after eating sweet or high-fat foods.

It can cause:

  • Nausea
  • Vomiting
  • Cramps
  • Diarrhea
  • Sweating
  • Weakness

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