Laparoscopic Roux-en-Y Gastric Bypass

The Procedure

 

Roux-en-Y gastric bypass (RYGB) is a type of weight-loss surgery. Weight-loss surgery is also called bariatric surgery. It’s often done as a laparoscopic surgery, with small incisions in the abdomen. This surgery reduces the size of your upper stomach to a small pouch about the size of an egg. The surgeon does this by stapling off the upper section of the stomach. This reduces the amount of food you can eat. 

Roux-en-Y gastric bypass

The surgeon then attaches this pouch directly to part of the small intestine called the Roux limb. This forms a “Y” shape. The food you eat then bypasses the rest of the stomach and the upper part of your small intestine. This reduces the amount of fat and calories you absorb from the foods you eat. It also reduces the amount of vitamins and minerals you absorb from food.

Most importantly, the rerouting of the food stream produces changes in gut hormones that promote satiety, suppress hunger, and reverse one of the primary mechanisms by which obesity induces type 2 diabetes.

Roux limb

What are the risks of gastric bypass weight-loss surgery?

Early complications that can occur

Late complications that can occur

What happens after Roux-en-Y gastric bypass surgery?

You may stay in the hospital for 1 to 2 days after the surgery. Talk with your doctor about wound care, safe pain medicines, and when you can start physical activity. Your doctor will tell you how often to change the dressing on your incision.

Tell your doctor right away if you have any of the below:

Post operative diet and vitamins

You will likely only have liquids for the first 1 to 2 weeks after surgery. Your doctor may slowly add soft food and then regular food to your diet about a month after surgery. You will be need to chew slowly and fully, and not to drink 30 minutes before or after you eat. Your initial weight-loss may occur quickly, so it’s important to get all of the nutrition and vitamins you need as you recover. Your doctor will prescribe vitamin and mineral supplements that your body may no longer absorb well from food alone.

To prevent nutritional problems after gastric bypass surgery, many doctors advise:

Long-Term Care

Because nutritional deficiencies can happen after this surgery, experts recommend that your blood be tested at least every 6 months for the rest of your life to ensure that you are getting the right amount of vitamins and minerals. During weight-loss, you may have body aches, dry skin, mood changes, and temporary hair thinning, and feel tired and cold. As your weight stabilizes, these problems should go away. 

Weight loss continues for about a year, and then will stop. After a year, you may be able to eat more if the pouch stretches. You should use the first year to develop good eating and exercise habits that will keep you from regaining weight. Along with follow-up appointments with your doctor and surgeon, you will likely see a dietitian who will teach you how and what to eat with your reduced stomach size. You may also need to see a psychologist to help you deal with the feelings and concerns over your changed lifestyle.

After the first year, it is best to follow up with your surgeon at least annually.

 
Full-length Laparoscopic Roux-en-Y Gastric Bypass with Dr. Jason Rizqallah, MD

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