How long does bariatric surgery take?

When researching bariatric surgery options, many people wonder how long bariatric surgery takes.

The short answer is that the duration of most bariatric surgeries is around 60 to 90 minutes. The provided times are merely guidelines; actual surgery times can vary depending on your medical history, BMI, and unique anatomy.

It’s also important to remember that the surgical procedure is just one component of a much longer process. Keep reading to learn more about how long most bariatric surgeries take and what you can expect with each procedure.

Lengths of Various Bariatric Surgeries

Bariatric surgeries work to achieve weight loss by either reducing the amount of food that a person can eat, by causing a malabsorption of nutrients, or a combination of gastric reduction and malabsorption of nutrients. Most gastric bypass surgeries are performed using laparoscopic surgical techniques, which are considered minimally invasive.

Most gastric bypass surgeries are performed using laparoscopic surgical techniques, which are considered minimally invasive.

Most bariatric surgeons recommend one of the following four bariatric surgery procedures for most of their patients.

Gastric Bypass Surgery: Approximately 90 Minutes

The procedure that people are most familiar with is the gastric bypass, which is considered to be the “gold standard” in bariatric procedures by the American Society for Metabloc and Bariatric Surgery (ASMBS).

While the procedure is commonly referred to as gastric bypass, the full medical name is Roux-en-Y gastric bypass (often abbreviated as RYGB).

During this type of surgery, the surgeon divides the top of the stomach from the rest of the stomach using surgical staples. This creates a small pouch that is capable of holding about 30 milliliters of food or liquid.

Gastric bypass surgery illustration

The surgeon then separates the small intestine into two sections. The lower section of the small intestine is then attached to the newly created, smaller stomach pouch. The upper part of the small intestine is then reconnected to the lower section of the small intestine.

This video shows a clear demonstration of the Roux-en-Y gastric bypass procedure:

Gastric bypass surgery makes a person feel full after eating small amounts of food. Bypassing a section of the small intestine reduces the absorption of calories and nutrients because it shortens the time that food spends in the small intestine.

Rerouting the food also generates changes in hormones, which suppress hunger and are responsible for inducing type 2 diabetes.

Vertical Sleeve Gastrectomy: One to Two Hours

The laparoscopic sleeve gastrectomy is a procedure in which the surgeon removes about 75% to 80% of the stomach. This reduces the stomach to roughly the size of a banana. This surgery is commonly known as the sleeve.

Similar to the gastric bypass surgery, sleeve gastrectomy makes patients feel full after eating small amounts of food. The sleeve has a greater impact on bodily hormones that affect hunger, satiety, and blood sugar control than gastric bypass surgery.

The ASMBS refers to short-term studies proving the sleeve is as effective as the Roux-en-Y gastric bypass when it comes to weight loss and diabetes control. Studies also show that the sleeve surgery is effective for improving type 2 diabetes for people without obesity issues. Complication rates of sleeve gastrectomy are slightly higher than gastric bypass surgery.

Adjustable Gastric Band: Approximately One Hour

The adjustable gastric band procedure is less invasive than the gastric bypass and sleeve procedures because it doesn’t require cutting the stomach or rerouting the intestines.

The procedure works by constricting the stomach and creating a sense of being full. The procedure is reversible and adjustable. It is commonly referred to simply as the band, but many people are more familiar with the popular gastric band system known as LAP-BAND.

In this procedure, the surgeon inserts an inflatable band around the upper portion of the stomach. As the band inflates, it creates a small stomach pouch above the band which limits food intake.

The surgeon reduces the size of the opening to the pouch gradually over time by filling the band with sterile saline. This can be done by injecting the saline solution through a port under the skin.

The main benefit to this procedure is that it doesn’t disrupt the normal process of food digestion and absorption, which means that it has a better rate of retaining vitamins and minerals than bypass and sleeve surgeries.

BPD-DS: One and a Half to Three Hours

The full name for this procedure is biliopancreatic diversion with duodenal switch gastric bypass, but most doctors and patients simply refer to it as BPD-DS.

BPD-DS can be a very effective surgery, but the increased complexity means this procedure takes longer than other bariatric surgery options.

Like the other types of bariatric surgery, this procedure starts by creating a small stomach pouch. Similar to sleeve gastrectomy, the surgeon removes a portion of the stomach, bypassing a large part of the small intestine.

The first section of the stomach is called the duodenum.  The surgeon divides the duodenum just past the outlet of the stomach and then brings a segment of the last part of the small intestine up and connects it to the newly created stomach.

This procedure creates a new path for digested food to enter the digestive system, emptying it directly into the last portion of the small intestine.

This procedure bypasses about three-fourths of the small intestines, which means that the food doesn’t mix with bile and pancreatic enzymes until the final stages of digestion. In this way, the body will absorb lesser amounts of calories and nutrients, especially protein and fat.

This procedure also affects the bodily hormones that determine hunger, satiety (the feeling of “fullness”) and blood sugars.

Most bariatric surgeons consider BPD/DS surgery to be the most effective surgery for the treatment of diabetes, as compared with the other three types of bariatric procedures listed here.

Long-Term Bariatric Surgery Time Frame

The actual surgical procedure is the shortest component of the total bariatric surgery process.

People considering bariatric surgery should consider the total time involved. Here some factors that can affect a patient’s surgery timeline:

  • Referral from your primary physician to a bariatric surgeon
  • Consultation with your bariatric surgeon
  • Weight at initial consultation
  • Dietary and exercise work required pre-operatively by the bariatric surgeon
  • Pre-operative scans and tests
  • Approval by the insurance company
  • Bariatric specialist’s surgical schedule
  • Post-operative dietary and exercise changes
  • Post-operative follow-up

Bariatric surgery is often considered a last resort for people who struggle with obesity. Because of the associated risks of surgery, most physicians and insurance companies require that patients try less invasive methods of weight loss before exploring options for surgery.

Bariatric physicians may also require patients to demonstrate that they can effectively lose some weight before approving the surgery.

Are You a Candidate for Bariatric Surgery?

The American Society for Metabolic and Bariatric Surgery (ASMBS) states that the best candidates for bariatric surgery fall into one of these three categories:

  1. Patients that have a body mass Index (BMI) that is equal or greater than 40, or persons that are more than 100 pounds overweight.
  2. Patients that have a BMI that is equal to or greater than 35 and have at least two obesity-related health concerns such as type II diabetes, hypertension, sleep apnea, respiratory disorder, non-alcoholic fatty liver disease, osteoarthritis, lipid abnormalities, gastrointestinal disorders, or heart disease.
  3. Patients demonstrating a long-term inability to lose weight and keep it off.

Use this online calculator to determine your BMI. This criterion is not the sole indicators for making the decision about who makes a good candidate for bariatric surgery.

Your primary physician and bariatric specialist will evaluate your personal health profile and help make the final determination whether bariatric surgery is a viable option for your weight loss.

Risks Associated With Bariatric Surgery

Bariatric surgery poses the same risks as any other type of surgery. General risks include:

  • Excessive bleeding
  • Bacterial infection
  • Edema (swelling)
  • Delayed healing
  • Bruising
  • Numbness
  • Blood clots
  • Complications from anesthesia

Additional risks of bariatric surgery include long-term vitamin and mineral deficiencies, particularly in vitamin B12, iron, calcium, and folate. Bariatric surgical patients will need to supplement their diets with vitamin and mineral supplements for the rest of their lives.

Patients that are considering bariatric surgery should discuss these and other risks with their doctors.

Preparing for Bariatric Surgery

Northeast Georgia Physicians Group details some of the pre-surgical procedures and protocols for bariatric surgery.

During a bariatric surgery consultation, patients will need to provide a full medical history and physical examination. They will also need to provide a summary that includes diet history, eating habits, and exercise regime.

The consultation will include a detail of the more conservative plans that the patient has tried and how long they’ve been working on weight loss control without surgery.

The surgeon will also require that patients obtain a psychological evaluation so that they understand that they need to make a commitment to post-operative instructions to get the best benefit of the surgery and meet their weight loss goals.

Recovery from Bariatric Surgery

When the surgeon’s work ends, the patient’s work on recovery is just beginning.

Bariatric surgery patients will need to begin walking right away after surgery. They should walk as much as they can tolerate.

It’s also important to follow the surgeon’s dietary instructions carefully. Creating good eating habits immediately after surgery sets the stage for new and better eating habits.

Bariatric surgery patients will also need a great deal of post-operative support. It helps to enlist the help of family and close friends. Other helpful resources include finding an accountability partner or joining a weight loss support group.

Sources

American Society for Metabolic and Bariatric Surgery https://asmbs.org/patients/who-is-a-candidate-for-bariatric-surgery

BMI calculator https://asmbs.org/patients/bmi-calculator

The American Society for Aesthetic Plastic Surgery http://www.surgery.org/consumers/patient-safety/surgical-risks-overview

Roux-en-Y Gastric Bypass Surgery https://www.youtube.com/watch?v=P83Vs9GQ0WI&feature=youtu.be

Northeast Georgia Physician’s Group http://www.ngpg.org/preop-bariatric-prep

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