The Roux-en-Y Gastric Bypass (RYGB) surgery is the most common bariatric surgery performed in the United States, and has been performed for well over 20 years. This procedure may be done either through an open approach (large incision) or the more common laparoscopic approach. Since no part of the stomach is removed using Roux-en-Y, it is less complicated and more commonly used by surgeons than other bariatric surgeries, and is also one of the most popular and effective surgeries.
The Process
During the first part of RYGB, a small pouch is created in the stomach with staples. This step restricts the amount of food the patient can consume to approximately one ounce. The remaining, larger part of the stomach is then separated from the pouch but is not removed.
The second step of this procedure involves dividing the small intestine just below the duodenum, the first section of the small intestine. Next, the second section of the small intestine, the jejunum, is brought up and is connected to the newly created pouch bypassing 3 to 5 ft. (about 20%) of the small intestine.
By bypassing the duodenum, absorption of nutrients and calories is prevented, resulting in significant weight loss. The gastric bypass essentially creates 2 channels in the intestinal tract - one for the food and a second for the digestive juices. The two channels are re-joined so that vitamins and protein can be adequately absorbed, but caloric absorption is reduced.
Traditional vs. Laparoscopic Surgery
Traditionally, the surgeon performs open surgery with one extended incision in the abdomen. The RYGB procedure can be done laparoscopically by making small incisions in the abdominal area with the guide of a small camera inserted in the abdominal cavity. The laparoscopic tool is used as a visual guide when inserted inside the abdomen. This procedure is less invasive, with less scarring and less healing time, and is faster than the traditional Roux-en-Y-gastric bypass surgery.
Advantages
Risks
As with all other major weight loss surgeries, risks can occur. The following complications are possible with Roux-en-Y surgery:
Recovery
RYGB patients can usually return home within 1-3 days of the surgery and will be prescribed medication to alleviate any pain and discomfort. Progress will be monitored during recovery and light activity such as walking may be encouraged by your surgeon. Basic daily routines can usually be resumed 2-3 weeks after the procedure. Patients will need to adhere to their new dietary and lifestyle changes.
Success with Roux-en-Y Gastric Bypass will be determined by your willpower and ability to adhere to your new lifestyle. If you stick to the plan and follow your doctor’s guidelines you will be able to achieve your goals of a healthier new life.
The Process
During the first part of RYGB, a small pouch is created in the stomach with staples. This step restricts the amount of food the patient can consume to approximately one ounce. The remaining, larger part of the stomach is then separated from the pouch but is not removed.
The second step of this procedure involves dividing the small intestine just below the duodenum, the first section of the small intestine. Next, the second section of the small intestine, the jejunum, is brought up and is connected to the newly created pouch bypassing 3 to 5 ft. (about 20%) of the small intestine.
By bypassing the duodenum, absorption of nutrients and calories is prevented, resulting in significant weight loss. The gastric bypass essentially creates 2 channels in the intestinal tract - one for the food and a second for the digestive juices. The two channels are re-joined so that vitamins and protein can be adequately absorbed, but caloric absorption is reduced.
Traditional vs. Laparoscopic Surgery
Traditionally, the surgeon performs open surgery with one extended incision in the abdomen. The RYGB procedure can be done laparoscopically by making small incisions in the abdominal area with the guide of a small camera inserted in the abdominal cavity. The laparoscopic tool is used as a visual guide when inserted inside the abdomen. This procedure is less invasive, with less scarring and less healing time, and is faster than the traditional Roux-en-Y-gastric bypass surgery.
Advantages
- Most people lose about 10-20 pounds a month the first year following surgery
- One year after surgery, weight loss can average 65% to 80% of excess body weight. After 10 years, some patients have maintained 50% of excess body weight loss.
- 96% of obesity related health conditions were improved or resolved in a recent study.
Risks
As with all other major weight loss surgeries, risks can occur. The following complications are possible with Roux-en-Y surgery:
- Vomiting may occur.
- Infections at the site of incision.
- Indigestion and heartburn especially if food is not chewed enough before swallowing.
- Due to the bypass aspect of this procedure, nutritional deficiency can result, especially Vitamin B12, Vitamin D, Calcium and Iron deficiency.
- For target results to be achieved, dietary discipline is required along with lifestyle changes which some people might find undesirable and frustrating. (Click here to view a sample post-op eating guide)
- Anastomotic leaks may occur (leaks between the pouch and the small intestine connection can break down) which can lead to what is called peritonitis. This usually will require re-operation.
- Problems with the staples can occur.
- Some people will develop hernias and ulcers.
- Dumping syndrome can occur, which happens as digested food is short-circuited in the bowel.
Recovery
RYGB patients can usually return home within 1-3 days of the surgery and will be prescribed medication to alleviate any pain and discomfort. Progress will be monitored during recovery and light activity such as walking may be encouraged by your surgeon. Basic daily routines can usually be resumed 2-3 weeks after the procedure. Patients will need to adhere to their new dietary and lifestyle changes.
Success with Roux-en-Y Gastric Bypass will be determined by your willpower and ability to adhere to your new lifestyle. If you stick to the plan and follow your doctor’s guidelines you will be able to achieve your goals of a healthier new life.
