What if you change your mind - is the gastric bypass reversible? 

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Sometimes people change their minds.  Many go into Weight Loss Surgery (WLS) unsure of whether it is for them and thus, they ask "Is the gastric bypass reversible if I don't like it?"  Often they receive a reassuring "YES" even from their surgeon but is this really true? 

If we think about the idea of reversal (going back to the same way it was before surgery), it doesn't make sense.  In a gastric bypass, the stomach is cut into two pieces, one small 1 oz pouch and a 39 oz bypassed part.  Three rows of staples secure the two pieces so that most of the time they don't leak.  So if you wish to reverse this surgery, how would you take the staples out and reconnect the two pieces?  Answer, you don't. 

There is also an intestinal bypass done with the gastric bypass - 18 inches to 5-7 feet of the small gut are bypassed and unused.  So what happens when that bypassed intestine sits 'out there' cooking with not much going through it?  Sometimes it rots (becomes necrotic).  Sometimes even the connected small gut can rot in places.  The tiny pouch produces little to no stomach acid and that's why it's said that the gastric bypass "cures" GERD i.e. acid reflux - because there IS NO acid to reflux!  Without stomach acid to sanitize the food, bacteria can have the freedom to do what it does best. Grow. And hungry bacteria eat at the gut. That's why the gut sometimes rots.

Some surgeons are honest about whether the gastric bypass is reversible.  Dr Louis Flancbaum tells his patients (and wrote in his book also) that the gastric bypass is like re-decorating your house.  It would be pretty impossible to go back to the way it was before surgery.

Surgeons can undo parts of the surgery and they call this a "takedown". They reconnect the stomach and small gut in order to allow the person more nourishment. 

 In a takedown surgery, a hole or 'stoma' is made in the larger piece of the stomach (the bypassed part) and the pouch piece is connected to the larger piece so that food which goes into the pouch travels to the larger stomach, gets digested and goes to the bypassed part of the intestine, the part which digests vitamins. 

Often during a takedown, they have to remove adhesions from the stomach (the body's reaction to surgery).  In one case I know, the takedown surgeon told the patient he had to spend TWO HOURS removing adhesions from her stomach and this only 18 months after the original surgery. I know a lady on our listserve who cannot be taken down because adhesions have totally obliterated her stomach in the 18 years after her surgery.  The best they can do for her is the stretch out the opening into the larger part of the stomach.  She knows when it's time to have this done when everything, even saliva, comes back up again.

In a takedown, they also 'amputate' any of the small gut or stomach which has rotted.

After a takedown, at least the patient is getting nutrition but they STILL have a reconfigured digestive tract with all the repercussions which go with it.  Bottom line is the gastric bypass changes the digestive tract forever so if you have any doubts, this surgery may not be for you.

Another thing with a takedown - if you ask some surgeons about it, they will tell you they've seldom had to takedown anyone.  This is true because most patients with a problem who approach their surgeons get the bums rush out of the office.  All those people whom I know, who have had takedowns had to search far and wide for a surgeon to DO the surgery.

As Trish, a WLS patient who had her VBG taken down in order to save her life, suggested, as a means of finding out how easy it is to get a doctor to takedown the gastric bypass, inquire among some NON WLS surgeons (since WLS surgeons most often do NOT do takedowns) to see how many actually have DONE take-downs!

Having an exit route is important especially with a life changing decision like WLS. Those selecting a gastric bypass should be aware of the fact that the gastric bypass surgery does NOT offer much of an exit route to the patient.

Sue Joan



ASBS website: www.asbs.org

also: studying medical documents and consultations on patient takedowns