Gastric Bypass (Roux-en-Y)

Gastric bypass surgery makes the stomach smaller by creating a small pouch at the top of the stomach using surgical staples. The smaller stomach is connected directly to the middle portion of the small intestine (jejunum), bypassing the rest of the stomach and the upper portion of the small intestine (duodenum). This allows food to bypass part of the small intestine.

You will feel full more quickly than when your stomach was its original size, which reduces the amount of food you eat and thus the calories consumed. Bypassing part of the intestine also results in fewer calories being absorbed. This leads to weight loss.

In normal digestion, food passes through the stomach and enters the small intestine, where most of the nutrients and calories are absorbed. It then passes into the large intestine (colon), and the remaining waste is eventually excreted.

This procedure can be done by making a large incision in the abdomen (an open procedure) or by making a small incision and using small instruments and a camera to guide the surgery (laparoscopic approach).

What to Expect After Surgery

Most people can return to their normal activities in 3 to 5 weeks.

After surgery, you'll need to make big,
permanent changes in how you eat:

• You can eat only a few ounces of food at a time. Your new stomach will only hold a tiny amount of food;
• You must eat very slowly and chew your food to mush. Otherwise, you may vomit often and have pain;
• You won't be able to drink for 30 minutes before you eat, during your meal, and for 30 minutes after you eat. There won't be room in your stomach for both drinks and solid food;
• You probably will need to take vitamins and supplements;
• You may have to avoid foods that contain simple sugars-like candy, juices, ice cream, condiments, and soft drinks. Simple sugars may cause a problem called dumping syndrome. This happens because food moves too quickly through the stomach and intestines. It can cause shaking, sweating, dizziness, rapid heart rate, and often severe diarrhea.

Risks and Complications

Risks common to all surgeries for weight loss include:

• An infection in the incision;
• A leak from the stomach into the abdominal cavity or where the intestine is connected (resulting in an infection called peritonitis);
• And a blood clot in the lung (pulmonary embolism);
• About one-third of all people having surgery for obesity develop gallstones or a nutritional deficiency condition such as anemia or osteoporosis.

Fewer than 10 out of 1000 people die after weight-loss surgery.

After a Roux-en-Y gastric bypass

• An iron and vitamin B12 deficiency occurs more than 30% of the time. About 50% of those with an iron deficiency develop anemia;
• The connection between the stomach and the intestines narrows (stomal stenosis) 5% to 15% of the time, leading to nausea and vomiting after eating;
• Ulcers develop 5% to 15% of the time;
• The staples may pull loose;
• Hernia may develop;
• The bypassed stomach may enlarge, resulting in hiccups and bloating;

How Do I Qualify for Gastric Bypass?

• You are at least 18 years old;
• You are 100 pounds overweight;
• Your body mass index (BMI) is 35 or higher and you have a health problem related to your weight, or your BMI is 40 or higher;
• You have tried to lose weight but have had only short-term success;
• You do not have a disease that may have caused you to be overweight;
• You are prepared to set a lifetime goal to make drastic, challenging, permanent changes to your eating habits and lifestyle;
• You are willing and able to return to your doctor for follow-up visits and band adjustments;
• You understand the information in the literature provided to you and the information shared by your surgeon.

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