Roux-en-Y Gastric Bypass

Once the most popular weight loss surgical option, the Roux-en-Y gastric bypass (RYGB) has been performed for over 50 years. After RYGB, a typical patient may expect to lose about 75% of their excess weight and improve their health dramatically.  A patient’s appetite is significantly depressed after RYGB, which can help patients make the necessary healthy dietary changes needed to be successful.

Roux-en-Y Gastric Bypass surgery is designed to help reduce the amount of food you eat by decreasing hunger and overall calorie absorption from fat. In addition to significant weight loss, RYGB dramatically reduces the health risks posed by obesity-related health conditions, including diabetes, sleep apnea, hypertension, and many others.

How can Gastric Bypass surgery help me achieve my goals?

Gastric Bypass surgery is a metabolic operation. This means that the operation alters the patient’s physiological response to fat loss. When dieting, the brain senses the loss of body fat and it decreases your metabolism so you burn fewer calories. The brain also causes your appetite to increase and make you feel less full when eating. The end result is weight regain! Luckily, after RYGB, the exact opposite occurs. In the face of body fat loss, appetite is suppressed, patients feel full more quickly, and their metabolism remains high, burning more calories. This allows the patient to lose significant weight and reach a new lower metabolic set point. After RYGB, patients are routinely free of serious health problems like diabetes, hypertension, and sleep apnea.

Procedure

The procedure is normally performed laparoscopically, using small incisions and surgical instruments. Small incisions make the surgery less invasive with less pain, fewer pulmonary complications, and fewer infections and less muscle-mass loss, and a speedier recovery.

The Gastric Bypass procedure involves dividing the stomach to create a small pouch out of the very top part of the stomach. This smaller stomach pouch then directs the food you eat directly into the small intestine, ultimately bypassing 95% of the stomach. It also bypasses about 10-15% of the small intestine, where nutrients and calories are absorbed. Doing so allows the patient to be satisfied with smaller food portions and also prevents efficient calorie absorption, promoting amazing weight loss. The malabsorption created by the RYGB is primarily for fat and vitamins and minerals. Carbohydrates and protein are absorbed fairly normally.

Advantages
  • Laparoscopic Gastric Bypass surgery is designed to minimize scarring and diminish total surgery and recovery time.
  • Patients have an expected excess weight loss of about 75% during the first post-operative year.
  • The weight loss is durable, with patients maintaining 50 to 60% of their excess body weight loss after 10 to 14 years.
  • Patients have excellent resolution of all comorbid conditions including diabetes, hypertension, and sleep apnea.
Risks
  • Because of the stomach and intestinal bypass, patients are at risk for developing serious nutritional deficiencies after RYGB. Patients are unable to absorb all of their required nutrition just from the food they eat. Life-long dietary supplementation is required for good health. The New Life Center for Bariatric surgery recommends a supplement regimen that meets or exceeds the recommendations of the American Society for Metabolic and Bariatric Surgery.
  • After RYGB, patients are at an increased risk for developing ulcers where the small intestine is attached to the stomach pouch. It is recommended to avoid the use of non-steroidal anti-inflammatory medications (NSAIDs) after surgery. Examples of NSAIDs include ibuprofen, Aleve®, Advil®, and naproxen. The other known cause of ulcers after RYGB is cigarette smoking.  Patients that smoke should not undergo RYGB.
  • In some cases, rapid emptying of the contents of the stomach into the small intestine, a condition referred to as “dumping syndrome,” may occur. Excessive amounts of food consumption or too much sugar can sometimes trigger dumping syndrome. This condition is not typically considered to be a serious health risk; however, the effects can be very uncomfortable. Weakness, faintness, nausea, sweating, and diarrhea can result from dumping syndrome. Some individuals may not be able to eat any kind of sweets following the surgery.

Our weight loss team will talk more with you about the risks of Gastric Bypass surgery during your initial consultation. We do everything possible to minimize risks and potential complications associated with this procedure, and we offer a comprehensive aftercare program to help ensure your safety during the weight loss process.

Recovery

Gastric Bypass surgery typically requires a one to two-night hospital stay. Oral pain medication is often all that’s necessary to control pain. Light activities, such as walking and stretching, are usually advised to help patients progress gradually throughout the recovery process. Most individuals who have sedentary office jobs can resume working in about two weeks. Resumption of formal exercise and unrestricted activity can often begin at about one month post-surgery.