Roux-en-Y Gastric Bypass
What is Roux-en Y Gastric Bypass Surgery?
The Roux-en-Y gastric bypass, commonly known as “gastric bypass,” has been a popular weight loss surgery for more than 50 years. Today, it’s performed using a minimally invasive laparoscopic technique. The name "Roux-en-Y" comes from the Y-shaped structure of the rerouted digestive tract. This surgery is designed to help people who struggle with obesity and its related health issue.How Does Gastric Bypass Work?
The gastric bypass procedure involves creating a small, egg-sized pouch in the stomach. The larger part of the stomach is then bypassed, meaning food doesn’t pass through it for digestion.
Next, a section of the small intestine that was connected to large stomach is joined to another part of the small intestine about 100-150 centimeters away, forming a Y-shape. This rerouting allows food to bypass part of the digestive tract.
Over time, stomach acids and digestive juices from the bypassed stomach, and the first part of the small intestine, mix with the food eaten.
Gastric bypass works in a few ways. The new, smaller stomach helps people feel fuller, leading to reduced calorie intake. Also, food doesn’t reach the first part of the small intestine, which means fewer nutrients are absorbed.
The surgery also changes how food moves through the digestive system, which reduces hunger and helps people feel full. This helps them lose weight and keep it off.
Often, the surgery improves heartburn and diabetes symptoms before weight is lost.
To maximize the benefits of gastric bypass, patient should maintain a healthy diet, avoid tobacco and use caution with certain medications like ibuprofen and naproxen.
Gastric Bypass Requirements & Qualifications
Insurance companies often have specific requirements for gastric bypass surgery eligibility. Make sure you meet the following criteria and verify with your insurance provider to confirm your candidacy.
Post-Gastric Bypass Surgery Diet
After bariatric surgery, you’ll follow a specific diet that slowly reintroduces different foods. It’s crucial to adhere to these stages to ensure proper stomach healing and reduce post-operative complications such as nausea, vomiting, food intolerances, diarrhea and dumping syndrome.
Drink a clear liquid diet consisting of the following:
- Water
- Broth
- Sugar-free Jell-O
- Sugar-free popsicles
Your primary goal in the hospital is to consume at least 64 ounces of water each day. Sip slowly and start with room temperature beverages. Cold or hot drinks can cause stomach spasms.
When you leave the hospital, you’ll follow a full liquid diet for 1-2 weeks, consisting of:
- Drinking at least 64 ounces of water daily
- Consuming 60 to 80 grams of protein daily from protein shakes
- Taking your multivitamin and calcium supplements
Full liquid foods should be consumed in portion sizes of a quarter cup or less, 2-3 times a day. This includes:
- Unsweetened apple sauce
- Sugar-free pudding or gelatin
- Light yogurt
- Cream soups or broth
- Tomato or vegetable juice
You may eat a puree diet during weeks three and four. Portion sizes should be a quarter cup or less per meal, and foods should be pureed to a smooth consistency. Pureed foods include:
- Cottage cheese or any cheese
- Refried beans
- Mashed banana
- Avocado
- Oatmeal
- Watermelon
- Other food pureed in a blender
You’ll start a soft diet when you hit week five after your bariatric surgery. This consists of soft foods you can cut easily with your fork, like:
- Ground meat
- Lean deli meats
- Scrambled eggs
- Soft fish or canned tuna
- Well-cooked vegetables
- Soft fruits
Portion sizes should be about one ounce of cooked protein and one ounce of vegetables. It’s important to avoid drinking 10 minutes before eating, while eating and 40 minutes after eating.
After being on a soft diet for at least one week, you can start introducing regular foods as tolerated. Regular foods include:
- Chicken breasts
- Other lean meats
- Raw vegetables
- Raw fruit
Measure your food, aiming for about one ounce of cooked protein and one ounce of vegetables per meal. It’s important to take small bites, about the size of a pea, and chew thoroughly. Eat your meals within 20 minutes, have three meals per day, don’t drink while eating and avoid snacking.
Gastric Bypass Side Effects & Recovery
Side effects are part of any surgical procedure. Fortunately, these reactions from gastric bypass surgery are not common. They include:
- Hair loss
- Dumping syndrome
- Diarrhea
- Vomiting
- Ulcers
- Bile gastritis
- Hernias
- Foreign body reaction
- Infection
- Oher post-operative problems
Excess skin is a common side effect of significant weight loss. Some people may feel self-conscious about it. Weight loss after surgery can continue for up to two years, and after that, you might consider skin removal surgery. A plastic surgeon can evaluate your needs and discuss your options. This cosmetic procedure might not be covered by insurance. You may need documentation of health issues related to the excess skin, such as rashes, back pain, or hygiene problems.
Return to work times vary. You’ll have a 10-to-20-pound weight restriction for two weeks following surgery. We encourage you to exercise as soon as you feel ready. For some, this is as early as one week. Most patients find that they need one or two weeks before going back to work. Others are back to work before that. You may feel tired the first week after your surgery, but you’ll actually feel more energetic as you lose weight.
We're dedicated to ensuring your surgery is as safe as possible. Thanks to significant advancements in surgical weight loss care over the past two decades, we can perform these procedures with an exceptionally low risk of complications. During your consultation, we'll carefully assess your individual risks and benefits. Remember, the dangers of obesity far surpass the risks associated with surgery.
Bariatric Surgery Compared
Picking the right surgical weight loss option is a big decision to help patients reach a healthy weight when they aren’t seeing results with diet and exercise alone. Each procedure has its benefits and risks, as with any surgery, so it’s important to know the difference between the three before choosing which is right for you. Your bariatric surgeon will support you in making the best decision based on your unique needs.
Sleeve Gastrectomy Pros and Cons
During a laparoscopic sleeve gastrectomy, also known as “sleeve” surgery, doctors surgically make the stomach smaller by using surgical staplers to remove about 80% of it. What’s left of the stomach is about the same size and shape as a banana.
Benefits
- Effective weight loss and improvement of obesity-related conditions
- Simple and shorter surgery time
- Appropriate for certain patients with high-risk medical conditions
- Can be the first step in weight loss for patients with severe obesity and used as a bridge to another surgery for additional weight loss
- Less risk of ulcer or stricture
Risks
- Procedure is non-reversible
- May worsen or cause new onset reflux or heart burn
Picking the right surgical weight loss option is a big decision to help patients reach a healthy weight when they aren’t seeing results with diet and exercise alone. Each procedure has its benefits and risks, as with any surgery, so it’s important to know the difference between the three before choosing which is right for you. Your bariatric surgeon will support you in making the best decision based on your unique needs.
Gastric Bypass Pros and Cons
Gastric bypass surgery involves dividing the stomach into two parts and bypassing a portion of the small intestine, reducing the amount of food your body can absorb. Gastric bypass is generally considered a more invasive weight loss surgery than gastric sleeve.
Benefits
- Reliable and long-lasting weight loss
- Effective for resolving obesity-associated conditions
- Highly refined and standardized technique
Risks
- More complex than sleeve gastrectomy or gastric band
- Results in more vitamin and mineral deficiencies than sleeve gastrectomy or gastric banding
- Risk for small bowel complications, obstructions or internal hernia
- Risk of developing ulcers, especially if using NSAIDs or tobacco
- Increased risk of forming kidney stones
- Risk for “dumping syndrome,” which involves feeling sick after eating or drinking, especially foods that are sweet
Picking the right surgical weight loss option is a big decision to help patients reach a healthy weight when they aren’t seeing results with diet and exercise alone. Each procedure has its benefits and risks, as with any surgery, so it’s important to know the difference between the three before choosing which is right for you. Your bariatric surgeon will support you in making the best decision based on your unique needs.
Gastric Band Surgery Pros and Cons
During gastric band surgery, a band is placed around the upper part of the stomach to restrict its size. This helps you feel fuller soon and eat less. It has the lowest risk of complications compared to gastric sleeve and gastric bypass surgery.
Benefits
- No division of the stomach or intestines
- Patients can go home the same day
- The band can be removed
- Lowest risk for vitamin and mineral deficiencies
Risks
- The band may need several adjustments and monthly office visits during the first year
- Slower and less weight loss than other surgical procedures
- Risk of band slipping or damaging the stomach over time (band erosion)
- Requires a foreign device to remain in the body
- Highest rate of re-operation
- Can result in swallowing problems and enlargement of the esophagus