Roux-en-Y Gastric Bypass Surgery
What is it?
Gastric bypass surgery is one of the most frequently performed procedures for morbid obesity in the US. Over the years the bypass has undergone significant revision and evolution into its current form. Some people are scared by the thought of having their anatomy rearranged, but truthfully it is an extremely safe procedure when performed by an experienced bariatric surgeon, and leads to amazing health improvements. For the appropriate candidate, the reward of surgery far outweighs the risk. The gastric bypass is still considered the gold standard for weight loss surgery, and the number of procedures performed each year has been growing at an astonishing rate.
How is it done?
The RNY Gastric bypass is a combination procedure using both restrictive and malabsorptive elements.
Restrictive: After surgery the volume of food it takes for you to get full is decreased. This is accomplished by taking your current 22 to 30 oz. stomach and separating out a smaller 1-2 oz. stomach (commonly called a pouch) for food to enter. Over about a year this pouch will tend to stretch somewhat, but will remain significantly smaller than your native stomach’s volume. By creating this smaller pouch, your body will feel full after eating a smaller portion of food. Right after surgery you will only require a small, 1- 2 oz., meal to fill your stomach and release chemical signals to your brain to tell it that you are full. At about a year it will take a few more ounces of food to cause this satiety, but it will still be significantly less than before surgery. The less food it takes you to feel full the more weight you can conceivably lose.
Malabsorptive: When we use the term bypass we mean that we are “bypassing” some of your stomach and small intestine. This rerouting reduces calorie and nutrient absorption, which, in turn, helps with weight loss. Along with the stomach, a piece of your small intestine will be bypassed, yet remain intact inside you. This part of your intestine will still allow for your body to contribute bile and digestive juices from your liver and gallbladder to help break down your food. Yet, by not having food transport through it, fewer calories will be absorbed causing more weight loss. Along with less calorie absorption also comes less nutrient absorption. The area of the small intestine that is bypassed is where a majority of your calcium, folic acid, iron, and B vitamins are absorbed from your diet. It is essential to adhere to the vitamin and dietary recommendations we provide, so as to avoid potential serious medical complications from nutrient deficiencies. This is why follow-up visits, labs and nutritional guidance are so vital after surgery!
What should I expect?
The biggest point of emphasis with the Gastric Bypass Roux-en-Y is that it is a tool to help you reach your weight loss goals, not a solution to obesity in and of itself. You can expect to lose 65% of your excess body weight, on average, over the course of a year. If you do not change your eating and exercise habits this may be slower or you may risk regain of weight over time.
What is the surgery like?
Surgery takes approximately one to two hours. This will vary based on your past surgical history and anatomy. The typical hospital stay is two nights. This procedure is almost always done laparoscopically through 5 to 6 small incisions in the abdomen. Laparoscopic surgery usually results in a shorter hospital stay, faster recovery, smaller scars, and less pain than open surgical procedures.
What kind of follow up will I need?
After surgery it is vital to your success to follow up with our office. You will be asked to come in for a 2 week post-operative visit with the surgeon and then a visit with the team at 6 weeks, 3 months, 6 months and then yearly. Those that follow up regularly tend to do the best with their weight loss outcomes.