The Gastric Bypass

The roux-en-y gastric bypass was first performed by Dr. Edward Mason over 50 years ago and is still considered the gold standard for weight loss surgery today.  Patients who undergo this procedure lose weight by eating smaller meals and and having less hunger.

Patients come to the hospital the day of surgery and are put to sleep by anesthesia.  Through a laparoscopic approach, the surgeon staples across the stomach, creating a pouch about the size of an egg and then bypassing 25% of the small intestines.  The new stomach pouch limits the amount of food patients can consume in one sitting.  In bypassing a portion of the intestines, we also limit the time food can mix with digestive juices, this again drives production of hormones that prolong satisfaction with less food.

The entire procedure usually takes about an hour and a half.  The recovery after surgery is essentially the same as the sleeve gastrectomy. Most patients go home in a day or two, once they are walking, breathing and drinking appropriately. Return to work varies between a week and a month based on physical requirements of your job. A few more vitamins are required after surgery compared to a sleeve gastrectomy because of the smaller pouch and the bypassing of some of the small intestine.

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  • The surgeon staples across the stomach, creating a pouch about the size of an egg 
  • About 25% of the small intestine is bypassed, meaning food spends less time in the digestive track. 
  • The new stomach pouch limits the amount of food patients can consume in one sitting.
  • Bypassing a portion of the intestines limits the time food can mix with digestive juices, leading to satisfaction with less food.

Risks specific to the gastric bypass include leaks at the staple lines and new connections created during the procedure. A leak could mean an extra few days in the hospital, additional antibiotics or another laparoscopic procedure. Long term risks include an ulcer at the connection between the pouch and the intestine as well as bowel obstructions and internal hernias.

One attribute specific to the bypass is dumping syndrome, which some patients view as both a positive or negative.  Patients who eat too much fat or sugar during a meal may “dump” or experience symptoms of nausea, sweating, fatigue, weakness and diarrhea.  It is your body’s way of telling you that you just ate the wrong thing.

Patients can expect to lose about 60% to 75% of their excess weight within the first year after surgery.*  Patients can also expect resolution or improvement of medical conditions such as hypertension and diabetes, often within the first few weeks or months after surgery.

*Results will vary between patients

  VIEW A ROUX-EN-Y GASTRIC BYPASS OPERATION

Gastric Bypass Advantages

  • Longest track record of all bariatric procedures
  • Excellent control of diabetes
  • Greatest control of heart burn, reflux or GERD
  • Most often included in bariatric benefits by all insurance companies
  • Risk of dumping syndrome helps patients avoid sugar and fat intake

Gastric Bypass Recovery

  • Hospital stay is typically 24 to 48 hours
  • Many patients return to normal activity within 1 to 2 weeks
  • Heavy lifting is restricted for roughly 4 weeks
 

Gastric Bypass Disadvantages

  • Risk of ulcer disease, particularly with tobacco users
  • More operative complications than other bariatric procedures
  • Reduced absorption of some nutrients
  • Unpleasant dumping syndrome may occur with fat or sugar intake

Gastric Bypass Risks

  • Standard surgical risks
  • Nausea and vomiting
  • Leaks from staple line
  • Small bowel obstruction
  • Nutritional deficiencies
  • Mortality rate: 0.1%
 
2016, Bariatric Specialists of North Carolina, a part of the EmergeOrtho network
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