Our Weight Loss Procedures
Roux-en-Y Gastric Bypass
The Roux-en-Y gastric bypass is often referred to as simply gastric bypass, and it is often considered the gold standard in bariatric surgery.
Roux-en-Y Gastric Bypass is another type of combined bariatric surgery that causes both restriction and malabsorption. It reduces the stomach size, but also involves bypassing a portion of the small intestine. These two steps translate to a reduction of the meal size being able to be consumed by you but also translates to a reduction of nutrients and calories being absorbed in the small intestine since the food intake bypasses part of the small intestine.
How does the Roux-en-Y Gastric Bypass work?
There are several ways that this procedure works. Like many other bariatric surgeries, it creates a small gastric stomach pouch that will allow a much smaller amount of food to be eaten, and this means that fewer calories will be taken in. This surgery also bypasses a small portion of the small intestines that makes the digestive enzymes, thereby leading to less nutrient and calorie absorption.
The most important factor is that the food stream is rerouted, and this creates gut hormone changes that make the patient feel fuller, suppress their hunger, and reverse the way that obesity often leads to type 2 diabetes.
As the term “gastric bypass” indicates, this operation reroutes the food stream past much of the patient’s stomach and the initial portion of the small intestine. It not only forces a smaller food intake, but it also reduces the amount of nutrients that are absorbed.
The Gastric Bypass Surgery
There are two main parts to a Roux-en-Y Gastric Bypass.
First, A small thumb-sized pouch is made by dividing the rest of the stomach from its top. This will hold about an ounce of volume. The small pouch allows at any one time just a small portion of food to be eaten.
Second, there is also a small bowel division with the help of a surgical stapler about 2 feet in length away from the stomach. Then, the end of the small intestine is attached to the pouch, called a gastrojejunostomy. Attached to the stomach’s remnant is the small intestine’s other end, and this is reconnected to the patient’s intestinal tract. This is known as a jejunojejunostomy and allows for digestive enzymes and stomach acids to mix with food.
The internal incisions are generally closed with sutures that absorb back into the body so that there are no stitches that have to be removed. The external incisions are often closed with absorbable sutures.
Advantages of Roux-n-Y Gastric Bypass
- It produces weight loss that is sustained long term as well as significant, and needs only limited dietary compliance to produce an excess weight loss of 60% to 80%.
- It restricts how much food can be taken in.
- It can cause conditions that will increase the expenditure of energy.
- It creates positive changes in the gut hormones that will enhance the feeling of fullness and reduce the appetite.
- It typically allows for more than 50% excess weight loss to be maintained.
- It does not need a foreign body to be implanted such as the silastic ring that is required in gastric banding.
- It offers better weight loss than does the adjustable gastric banding.
- The procedure is a combination of methods, offering malabsorptive effects as well as restriction.
- There is a long and full clinical database for this procedure.
Risks of Roux-n-Y Gastric Bypass:
- There is a risk of developing nutrition deficiencies, and this risk is higher than with other restrictive surgeries. A gastric bypass has food skip being in the duodenum, where most calcium and iron are absorbed. This may lead to a long-term deficiency in vitamins and minerals like iron, calcium, vitamin B12, and folate.
- Menstruating women may develop anemia because of the B12 and iron malabsorption.
- Decreased calcium absorption can lead to metabolic bone disease and osteoporosis.
- Because the stomach is resected and stapled, gastric leaks can occur.
- It can cause patients to have dumping syndrome. This condition results from the contents of the stomach moving through the small intestine too quickly. This can cause diarrhea, sweating, faintness, weakness, and nausea, and it is especially a risk after eating sweet foods.
- Technically, this is an operation that is more complicated than Sleeve Gastrectomy and Gastric Banding, and this can potentially mean higher rates of complications.
- It requires that patients adhere to a set of dietary recommendations, taking vitamin and mineral supplements for life, and comply with all follow-ups.