Laparoscopic Roux En Y Gastric Bypass
Gastric bypass surgery is a combination restrictive and malabsorptive weight loss surgery procedure. With this procedure, a small stomach pouch is created. A Y-shaped portion of the small intestine is attached directly to the pouch. The opening between the new stomach and intestine is also made smaller. The decreased size of the stomach causes a feeling of fullness as soon as capacity is reached. This is a signal to stop eating. Bypassing a portion of the small intestine results in fewer calories being absorbed. The restriction in volume combined with the malabsorptive process causes weight loss.
- Laparoscopic procedure
- Less post-operative pain
- Minimal scarring
- Shorter hospital stay
- Reduction of possible complications
- Faster recovery
- Resolution of type 2 diabetes in 83.8% of patients
- 75.4% resolution of hypertension
- 95% improvement of hypercholesterolemia
- 96% reduction of total co-morbidities
- Reduced rate of developing cancer, cardiovascular disease, endocrinological disorders, musculoskeletal problems, and pulmonary disorders
- Improved physical functioning
- Improved physical appearance
- Overall improved quality of life
- Requires a lifelong commitment
- Involves both risks and benefits
- Vitamin/Mineral supplementation
- Potential for open procedure
What to Expect
This surgery usually involves a two night stay in the hospital. Most people return to normal activities within 2 to 3 weeks.
Gastric bypass surgery results in malabsorption and therefore requires a commitment to life-long vitamin supplementation and follow-up.
High concentrations of sugar may result in "dumping syndrome." This reaction serves as a reminder to follow dietary recommendations and helps to maintain weight loss.
Exercise is integral to weight loss success, especially in the maintenance period. Prior to having surgery, people should develop an exercise plan to assist in their weight loss.
Psychological support is important throughout the weight loss phase. People considering gastric bypass surgery should attend a support group to assist them in adjusting to the changes in their life following surgery.
Frequently Asked Questions
- Who is a candidate for Gastric Bypass Surgery?
- You must be 18 years of age or older
- Your Body Mass Index (BMI) must be greater than 35 kg/m2 (approximately 80 pounds over ideal body weight) with significant medical conditions directly related to or influenced by your obesity; or your Body Mass Index must be greater than 40, with or without any medical conditions directly related to or influenced by your obesity.
- You have been morbidly obese for at least 5 years
- You have tried and been unsuccessful with medically supervised diets
- You are prepared to make substantial changes in your dietary intake, eating habits, and level of physical activity
- You are willing to commit to regular follow-up visits with your surgeon and the multidisciplinary team
- How long will I be out of work after surgery?
- Patients typically return to work in approximately 2-3 weeks.
- The time you will need to recover may vary based on the type of physical activity involved in your employment.
- How much weight can I anticipate losing?
- Weight loss is the most rapid during the first six weeks following surgery.
- Most patients lose up to 75% of their excess weight loss in the first 12 months following surgery.
- Weight loss is dependent upon various factors, including pre-operative weight, adherence to dietary recommendations, and ability to incorporate physical activity into your daily lifestyle.
- Does gastric bypass surgery require frequent follow-up to my surgeon?
- Follow-up is scheduled at regular intervals after surgery to assess your weight loss, change in comorbid conditions, ability to advance and tolerate your diet, to provide continued psychological support, and to provide continued nutritional counseling.
- Lab work is required at specific intervals following surgery due to the potential for malabsorption and nutritional deficiencies.
- Will I be sick a lot after the surgery?
- The bypass will limit the amount of food you are able to eat prior to feeling full. If you are nauseated, it may actually indicate that you are hungry and need to eat. If you are experiencing vomiting, it may signal that you are either overeating or eating too quickly to experience the initial sensation of fullness. It may also indicate a narrowing of the outlet from the pouch to the intestines. If you experience persistent nausea and vomiting, you should contact the surgeon for evaluation.
- How long will I be on a liquid diet after surgery?
- The day after surgery you will begin a sugar free clear liquid diet.
- The second day after surgery, your diet will be progressed to a full liquid diet.
- Week three you will progress to a pureed diet and week four to a soft diet.
- The final phase of the diet will be when you begin to incorporate solid foods into your diet.
- Our program dietitian will work with you as you dvance your diet. It will be important to adhere to the recommended schedule for advancement to prevent any complications
- Will I need to take vitamins and supplements for life?
- It is recommended that you take a multivitamin, iron, B12, and calcium following gastric bypass surgery due to the malabsorption caused by the procedure.
- Regular lab work will be ordered to monitor your level of absorption and adjustment to your vitamin regimen will be made accordingly.
- Will I be able to take regular medications?
- Initially, all medications must be either crushed, liquid, chewable or spray form due to post-operative swelling and the narrowing of the outlet between the pouch and the intestines.
- Medications should be brought in to your follow-up appointments to determine whether or not they will need to be continued to be taken in these formats. Smaller pills are usually easy to tolerate after the first 4 to 6 weeks following surgery.
- Extended release or sustained release medications should never be crushed or opened if in capsule form to prevent toxicity. Your pharmacist can tell you if any of your medications are extended/sustained release. You may need to request alternate dosing from your physician prior to surgery.
- NSAIDS and aspirin will cause irritation to the stomach pouch and should be avoided after surgery. If you are in any doubt as to whether you should avoid a newly prescribed medication, please check with your surgeon.
- What is "dumping syndrome?"
- This condition can occur following surgery when high sugar foods are consumed.
- The outcome may vary and include vomiting, nausea, weakness, sweating, faintness, and diarrhea.